Provider Demographics
NPI:1649661778
Name:FRANTZ, AMANDA LYNN (ASW # 107466)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:ASW # 107466
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 E FIR AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3865
Mailing Address - Country:US
Mailing Address - Phone:559-326-7775
Mailing Address - Fax:
Practice Address - Street 1:1781 E FIR AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3865
Practice Address - Country:US
Practice Address - Phone:559-326-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1074661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical