Provider Demographics
NPI:1447310016
Name:LEWIS-AMATO, AMANDA J (LMFT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:J
Last Name:LEWIS-AMATO
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 1:2333 1ST AVE
Mailing Address - Street 2:102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1596
Mailing Address - Country:US
Mailing Address - Phone:619-750-4185
Mailing Address - Fax:619-825-8388
Practice Address - Street 1:2333 1ST AVE
Practice Address - Street 2:102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1596
Practice Address - Country:US
Practice Address - Phone:619-750-4185
Practice Address - Fax:619-825-8388
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist