Healthcare Provider Details

I. General information

NPI: 1225066426
Provider Name (Legal Business Name): HEATHER L AMITRONE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16105 SAND CANYON AVE STE 220
IRVINE CA
92618-3780
US

IV. Provider business mailing address

200 WELLESLEY TRADE LN
CARY NC
27519-5576
US

V. Phone/Fax

Practice location:
  • Phone: 949-557-0275
  • Fax:
Mailing address:
  • Phone: 919-363-7546
  • Fax: 919-363-3616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA050980
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12283
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: