Healthcare Provider Details

I. General information

NPI: 1922631886
Provider Name (Legal Business Name): AMANDA BARBANICA MCCURDY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA KRISTINE BARBANICA PA-C

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2182 EAST ST
CONCORD CA
94520-2012
US

IV. Provider business mailing address

3130 BALFOUR RD STE. D #383
BRENTWOOD CA
94513
US

V. Phone/Fax

Practice location:
  • Phone: 925-685-4224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: