Healthcare Provider Details

I. General information

NPI: 1710857396
Provider Name (Legal Business Name): AMANDA CANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S VILLA AVE
WILLOWS CA
95988-2959
US

IV. Provider business mailing address

294 GABLE DR
ORLAND CA
95963-8151
US

V. Phone/Fax

Practice location:
  • Phone: 530-934-6575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: