Healthcare Provider Details

I. General information

NPI: 1073214268
Provider Name (Legal Business Name): AMBER PREHEIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12090 E SIERRA AVE
CLOVIS CA
93619-9485
US

IV. Provider business mailing address

12090 E SIERRA AVE
CLOVIS CA
93619-9485
US

V. Phone/Fax

Practice location:
  • Phone: 559-393-4182
  • Fax:
Mailing address:
  • Phone: 559-393-4182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: