Provider Demographics
NPI:1841379278
Name:HARPST, AMANDA CHRISTINE (SLP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:HARPST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19772 MACARTHUR BLVD
Mailing Address - Street 2:STE NO. 225
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2413
Mailing Address - Country:US
Mailing Address - Phone:949-431-0852
Mailing Address - Fax:866-800-7766
Practice Address - Street 1:19772 MACARTHUR BLVD
Practice Address - Street 2:STE NO. 225
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2413
Practice Address - Country:US
Practice Address - Phone:949-431-0852
Practice Address - Fax:866-800-7766
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP19468235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19468OtherCA STATE LICENSE
12131935OtherCAQH