Healthcare Provider Details

I. General information

NPI: 1144163130
Provider Name (Legal Business Name): AMANDA COLWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 COHASSET RD STE 140
CHICO CA
95973-5405
US

IV. Provider business mailing address

440 NORMAL AVE APT 16
CHICO CA
95928-5547
US

V. Phone/Fax

Practice location:
  • Phone: 702-695-2266
  • Fax:
Mailing address:
  • Phone: 702-695-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: