Provider Demographics
NPI:1366058505
Name:MCNAMARA, AMANDA LAUREN RAMOS LIBERTO (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LAUREN RAMOS LIBERTO
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3779
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-0964
Mailing Address - Country:US
Mailing Address - Phone:858-869-3256
Mailing Address - Fax:
Practice Address - Street 1:2130 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-2528
Practice Address - Country:US
Practice Address - Phone:707-345-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37633235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist