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General NPI Number Information
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NPI Number | 1720599632
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Entity Type | Individual
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Provider Name | CORAL ALEJANDRA AMADOR M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 707 14TH ST
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City | MODESTO
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State | CA
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Zip | 95354-2506
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Country | US
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Telephone | 209-525-5401
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Fax | 209-558-4230
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Provider Business Mailing Address
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Address Line | 800 SCENIC DR
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City | MODESTO
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State | CA
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Zip | 95350-6131
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Country | US
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Telephone | 209-552-2743
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 135941
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License Number State | CA
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