Provider Demographics
NPI:1962640284
Name:MITCHELL, AMBER CHRISTINE (BA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:CHRISTINE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 5TH ST.
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95776
Mailing Address - Country:US
Mailing Address - Phone:530-753-0220
Mailing Address - Fax:
Practice Address - Street 1:2100 5TH ST.
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95776
Practice Address - Country:US
Practice Address - Phone:530-753-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst