Healthcare Provider Details

I. General information

NPI: 1932381712
Provider Name (Legal Business Name): AMBER R WINTER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 SHAW AVE STE 116
CLOVIS CA
93611-4211
US

IV. Provider business mailing address

1575 SHAW AVE STE 116
CLOVIS CA
93611-4211
US

V. Phone/Fax

Practice location:
  • Phone: 559-628-0552
  • Fax: 559-793-7278
Mailing address:
  • Phone: 559-628-0552
  • Fax: 559-793-7278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number943889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: