Healthcare Provider Details

I. General information

NPI: 1053135871
Provider Name (Legal Business Name): AMARIS GISELLE ARMENDARIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 DWIGHT RD
ELK GROVE CA
95758-6456
US

IV. Provider business mailing address

7962 ARROYO VISTA DR APT 5
SACRAMENTO CA
95823-4901
US

V. Phone/Fax

Practice location:
  • Phone: 916-427-7141
  • Fax:
Mailing address:
  • Phone: 209-242-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: