Provider Demographics
NPI:1356039325
Name:MILLIGAN, AMANDA (APCC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1735
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:95258-1735
Mailing Address - Country:US
Mailing Address - Phone:209-200-3377
Mailing Address - Fax:
Practice Address - Street 1:705 CYPRESS RUN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CA
Practice Address - Zip Code:95258-9185
Practice Address - Country:US
Practice Address - Phone:209-200-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health