Provider Demographics
NPI:1891828570
Name:TINGLER, AMANDA ELISE (MS MFTI)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ELISE
Last Name:TINGLER
Suffix:
Gender:F
Credentials:MS MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6518 LONETREE BLVD
Mailing Address - Street 2:174
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5874
Mailing Address - Country:US
Mailing Address - Phone:916-402-8810
Mailing Address - Fax:
Practice Address - Street 1:6518 LONETREE BLVD
Practice Address - Street 2:174
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5874
Practice Address - Country:US
Practice Address - Phone:916-402-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA51059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist