Provider Demographics
NPI:1780096594
Name:FLORES, AMANDA SYLVIA (LMFT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SYLVIA
Last Name:FLORES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91708-0312
Mailing Address - Country:US
Mailing Address - Phone:909-497-4740
Mailing Address - Fax:
Practice Address - Street 1:405 S STATE COLLEGE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5727
Practice Address - Country:US
Practice Address - Phone:909-497-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist