Doctor Name: | AMANDA MICHELE SERINO |
NPI Number: | 1023314515 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 64690 |
Business Practice Address: | 520 W Palmdale Blvd Ste D Palmdale, CA - 935514230 |
Business Phone Number: | 6615758395 |
Business Fax Number: | |
Mailing Address: | 23632 Via Clasico, VALENCIA |
State: | CA |
Postal Code: | 913552647 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/01/2011 |
NPI Last Update Date: | 02/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 64690 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |