Healthcare Provider Details

I. General information

NPI: 1043997455
Provider Name (Legal Business Name): AMANDA CISLER PHD, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 FOOTHILL LN
OJAI CA
93023-1714
US

IV. Provider business mailing address

820 FOOTHILL LN
OJAI CA
93023-1714
US

V. Phone/Fax

Practice location:
  • Phone: 661-221-3867
  • Fax:
Mailing address:
  • Phone: 661-221-3867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: