Provider Demographics
NPI:1386328144
Name:MORALES-KLINGER, AMANDA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:MORALES-KLINGER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 BIXBY VILLAGE DR APT 25
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-6308
Mailing Address - Country:US
Mailing Address - Phone:949-648-2800
Mailing Address - Fax:
Practice Address - Street 1:19772 MACARTHUR BLVD STE 260A
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2413
Practice Address - Country:US
Practice Address - Phone:949-474-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist