Provider Demographics
NPI:1477266534
Name:CECI, AMANDA (BA, RBT)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:CECI
Suffix:
Gender:F
Credentials:BA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38048 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5020
Mailing Address - Country:US
Mailing Address - Phone:510-456-8203
Mailing Address - Fax:
Practice Address - Street 1:9025 ALCOSTA BLVD
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4063
Practice Address - Country:US
Practice Address - Phone:925-399-1459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-22-207676106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician