Provider Demographics
NPI:1982043519
Name:PREIKSCHAT, AMANDA RACHEL (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:RACHEL
Last Name:PREIKSCHAT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 GLENDORA DR
Mailing Address - Street 2:APT E
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3769
Mailing Address - Country:US
Mailing Address - Phone:845-519-4579
Mailing Address - Fax:
Practice Address - Street 1:700 LAWRENCE EXPY
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19101235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist