Provider Demographics
NPI:1619696341
Name:BARROSO, AMANDA (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BARROSO
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 SAINT CHARLES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3969
Mailing Address - Country:US
Mailing Address - Phone:805-497-1700
Mailing Address - Fax:805-497-1066
Practice Address - Street 1:696 HAMPSHIRE RD # 180A
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2699
Practice Address - Country:US
Practice Address - Phone:805-497-1700
Practice Address - Fax:805-497-1066
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand