Provider Demographics
NPI:1609513498
Name:STROMSHEIM, AMANDA (SUDRC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:STROMSHEIM
Suffix:
Gender:F
Credentials:SUDRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6327 BAINE AVE APT D
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-4048
Mailing Address - Country:US
Mailing Address - Phone:510-673-0410
Mailing Address - Fax:
Practice Address - Street 1:6327 BAINE AVE APT D
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4048
Practice Address - Country:US
Practice Address - Phone:510-673-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)