Provider Demographics
NPI:1083132864
Name:CLINE, AMANDA CATHARINE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CATHARINE
Last Name:CLINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CATHARINE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 PIEDMONT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2869
Mailing Address - Country:US
Mailing Address - Phone:619-363-2502
Mailing Address - Fax:
Practice Address - Street 1:604 PIEDMONT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-2869
Practice Address - Country:US
Practice Address - Phone:619-363-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA125647OtherLMFT #