MEDICARE: AMANDA KRISTINE PENZA

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
1	235Z00000X	Speech-Language Pathologist	RPE21534	CA

General Provider Information

NPI Number	:	1265391304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA KRISTINE PENZA

Provider Business Mailing Address
First Line	:	36932 RED OAK ST
Second Line	:
City	:	WINCHESTER
State	:	CA
Zip	:	92596-9193
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29992 HUNTER RD
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-4765
Country	:	US
Telephone Number	:	951-299-2220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ AMANDA KRISTINE PENZA ” Practice Location

Language	Start Address	Practice Location

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