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NPI Code Detail

MEDICARE: STEPHANIE AMODO

MEDICARE: STEPHANIE AMODO
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 TechnicianRBT-16-13763CA

General Provider Information

NPI Number : 1841792561
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE AMODO
Provider Business Mailing Address
First Line : 1200 E WASHINGTON AVE
Second Line :
City : REEDLEY
State : CA
Zip : 93654-3595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E WASHINGTON AVE
Second Line :
City : REEDLEY
State : CA
Zip : 93654-3595
Country : US
Telephone Number : 559-305-7145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2018
Last Update Date : 03/08/2018

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Directions to “ STEPHANIE AMODO ” Practice Location

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