Provider Demographics
NPI:1346075850
Name:FRAENKEL, AMANDA JEANETTE (PT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEANETTE
Last Name:FRAENKEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:JEANETTE
Other - Last Name:ARSENAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12834 SHADOWLINE ST
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-6405
Mailing Address - Country:US
Mailing Address - Phone:818-517-5423
Mailing Address - Fax:
Practice Address - Street 1:12834 SHADOWLINE ST
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-6405
Practice Address - Country:US
Practice Address - Phone:818-517-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist