Healthcare Provider Details

I. General information

NPI: 1538677562
Provider Name (Legal Business Name): AMANDA MACARTNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 EMBARCADERO STE 310
OAKLAND CA
94606-5227
US

IV. Provider business mailing address

1900 EMBARCADERO STE 310
OAKLAND CA
94606-5227
US

V. Phone/Fax

Practice location:
  • Phone: 510-832-4383
  • Fax:
Mailing address:
  • Phone: 510-832-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-28814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: