Provider Demographics
NPI:1992098206
Name:KAGGIE, AMBER (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:KAGGIE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:FRENZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2093
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-1093
Mailing Address - Country:US
Mailing Address - Phone:951-290-7449
Mailing Address - Fax:951-414-3774
Practice Address - Street 1:1401 21ST ST STE R
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5226
Practice Address - Country:US
Practice Address - Phone:951-290-7449
Practice Address - Fax:951-414-3774
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31196103T00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program