Organization Active NPI

Amanda Kendrick, Psy.D., Licensed Clinical Psychologist Inc.

  • Psychologist
  • Fullerton, CA
National Provider Identifier
1174302483
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
AMANDA KENDRICK, PSY.D., LICENSED CLINICAL PSYCHOLOGIST INC.
Practice address
1605 W West Ave
Fullerton, CA 92833-3806
Phone
(678) 871-6134
Fax
(714) 870-4106
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Kendrick, PSY.D.NPI 1154516409
Title
Clinical Psychologist
Phone
(714) 457-6858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1605 W West Ave
Fullerton, CA 92833-3806

Mailing address

2271 W Malvern Ave # 88
Fullerton, CA 92833-2106

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1174302483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 W MALVERN AVE # 88",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332106",
            "fax_number": "714-870-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W WEST AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333806",
            "telephone_number": "678-871-6134",
            "fax_number": "714-870-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA KENDRICK, PSY.D., LICENSED CLINICAL PSYCHOLOGIST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "714-457-6858",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.