Healthcare Provider Details

I. General information

NPI: 1710273214
Provider Name (Legal Business Name): AMBER J HEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N MURRAY ST
BANNING CA
92220-5528
US

IV. Provider business mailing address

1210 E LUGONIA AVE APT H
REDLANDS CA
92374-2627
US

V. Phone/Fax

Practice location:
  • Phone: 951-849-8812
  • Fax:
Mailing address:
  • Phone: 714-292-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: