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General NPI Number Information
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NPI Number | 1265710511
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Entity Type | Individual
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Provider Name | AMANDA FEHLENBERG
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Gender | Female
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 6180 BROCKTON AVE STE 202
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City | RIVERSIDE
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State | CA
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Zip | 92506-2233
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Country | US
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Telephone | 706-537-2557
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Fax |
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Provider Business Mailing Address
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Address Line | 25071 PROSPECT AVE # A
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City | LOMA LINDA
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State | CA
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Zip | 92354-2959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | APPLIED FOR
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License Number State | CA
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