Provider Demographics
NPI:1316000508
Name:KONYN, AMANDA BRIANNA
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BRIANNA
Last Name:KONYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2393 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CA
Mailing Address - Zip Code:95938-9620
Mailing Address - Country:US
Mailing Address - Phone:530-521-4680
Mailing Address - Fax:
Practice Address - Street 1:280 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2210
Practice Address - Country:US
Practice Address - Phone:530-879-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW291221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical