Provider Demographics
NPI:1215363932
Name:KRESS, AMANDA RENEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:RENEE
Last Name:KRESS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:RENEE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:189 3RD ST APT A302
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4365
Mailing Address - Country:US
Mailing Address - Phone:360-927-3334
Mailing Address - Fax:
Practice Address - Street 1:189 3RD ST APT A302
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4365
Practice Address - Country:US
Practice Address - Phone:360-927-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20780225100000X
CA43011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist