Healthcare Provider Details

I. General information

NPI: 1043177710
Provider Name (Legal Business Name): AMANDA ALEXANDRIA STINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 KATELLA AVE
STANTON CA
90680-3150
US

IV. Provider business mailing address

421 S BROOKHURST ST STE 1225
ANAHEIM CA
92804-2413
US

V. Phone/Fax

Practice location:
  • Phone: 949-273-0560
  • Fax:
Mailing address:
  • Phone: 562-305-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: