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NPI Code Detail

MEDICARE: AMANDA JOY GHATTAS

MEDICARE: AMANDA JOY GHATTAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1063369627
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JOY GHATTAS
Provider Business Mailing Address
First Line : 1063 MCGAW AVE STE 100
Second Line :
City : IRVINE
State : CA
Zip : 92614-5554
Country : US
Telephone Number : 714-834-1111
Fax Number :
Provider Business Practice Location Address
First Line : 1063 MCGAW AVE STE 100
Second Line :
City : IRVINE
State : CA
Zip : 92614-5554
Country : US
Telephone Number : 714-834-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ AMANDA JOY GHATTAS ” Practice Location

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