Provider Demographics
NPI:1770194110
Name:STEINER, AMANDA MOSSMAN (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MOSSMAN
Last Name:STEINER
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 BLUEBERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8885
Mailing Address - Country:US
Mailing Address - Phone:303-501-0811
Mailing Address - Fax:
Practice Address - Street 1:3609 BLUEBERRY HILL DR
Practice Address - Street 2:
Practice Address - City:SHINGLE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95682-8885
Practice Address - Country:US
Practice Address - Phone:303-501-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5518103K00000X
CA28118103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst