Provider Demographics
NPI:1578107033
Name:TRENT, AMY B (AMFT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:TRENT
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 TEHAMA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1615
Mailing Address - Country:US
Mailing Address - Phone:530-515-5686
Mailing Address - Fax:530-245-9188
Practice Address - Street 1:1726 TEHAMA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1615
Practice Address - Country:US
Practice Address - Phone:530-515-5686
Practice Address - Fax:530-245-9188
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT115553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health