Provider Demographics
NPI:1154729978
Name:ZAMANI, AMANDA (ATC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ZAMANI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 VIA COLINAS
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5045
Mailing Address - Country:US
Mailing Address - Phone:818-487-6655
Mailing Address - Fax:
Practice Address - Street 1:3700 COLDWATER CANYON AVE
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2301
Practice Address - Country:US
Practice Address - Phone:818-487-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000100142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer