Provider Demographics
NPI:1649441114
Name:GOLETTO, AMANDA LYNN (MA)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:LYNN
Last Name:GOLETTO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6666 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3334
Mailing Address - Country:US
Mailing Address - Phone:925-201-6200
Mailing Address - Fax:
Practice Address - Street 1:6666 OWENS DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3334
Practice Address - Country:US
Practice Address - Phone:925-201-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health