Healthcare Provider Details

I. General information

NPI: 1568117539
Provider Name (Legal Business Name): AMY RACHELLE KIRKPATRICK CMPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 LOVERIDGE RD FL 2
PITTSBURG CA
94565-5117
US

IV. Provider business mailing address

2311 LOVERIDGE RD FL 2
PITTSBURG CA
94565-5117
US

V. Phone/Fax

Practice location:
  • Phone: 925-431-2964
  • Fax:
Mailing address:
  • Phone: 925-431-2964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-PQAKFV
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: