Provider Demographics
NPI:1396181574
Name:CODDINGTON, AMANDA (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28720 ROADSIDE DR
Mailing Address - Street 2:STE 335
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-3464
Mailing Address - Country:US
Mailing Address - Phone:562-713-0595
Mailing Address - Fax:
Practice Address - Street 1:28720 ROADSIDE DR
Practice Address - Street 2:STE 335
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-3464
Practice Address - Country:US
Practice Address - Phone:818-532-7442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor