Healthcare Provider Details

I. General information

NPI: 1447008008
Provider Name (Legal Business Name): AMANDA MCINERNEY MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MACARTHUR BLVD STE 14
OAKLAND CA
94605-5260
US

IV. Provider business mailing address

10700 MACARTHUR BLVD STE 14
OAKLAND CA
94605-5260
US

V. Phone/Fax

Practice location:
  • Phone: 510-981-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038350
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95300155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: