Provider Demographics
NPI:1679164644
Name:STRAHAN, AMANDA (LEP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:STRAHAN
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:STRAHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LEP
Mailing Address - Street 1:824 W MILLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8553
Mailing Address - Country:US
Mailing Address - Phone:559-836-3413
Mailing Address - Fax:
Practice Address - Street 1:824 W MILLBROOK ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-8553
Practice Address - Country:US
Practice Address - Phone:559-836-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP4389103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool