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General NPI Number Information
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NPI Number | 1174302483
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Entity Type | Organization
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Legal Business Name | AMANDA KENDRICK, PSY.D., LICENSED CLINICAL PSYCHOLOGIST INC.
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1605 W WEST AVE
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City | FULLERTON
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State | CA
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Zip | 92833-3806
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Country | US
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Telephone | 678-871-6134
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Fax | 714-870-4106
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Provider Business Mailing Address
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Address Line | 2271 W MALVERN AVE # 88
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City | FULLERTON
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State | CA
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Zip | 92833-2106
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Country | US
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Telephone |
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Fax | 714-870-4106
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | AMANDA KENDRICK
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Credential | PSY.D.
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Telephone | 714-457-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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