Healthcare Provider Details

I. General information

NPI: 1821903642
Provider Name (Legal Business Name): AMANDA MARIE PRICE MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 VIA MALLORCA UNIT 8
LA JOLLA CA
92037-2585
US

IV. Provider business mailing address

8585 VIA MALLORCA UNIT 8
LA JOLLA CA
92037-2585
US

V. Phone/Fax

Practice location:
  • Phone: 661-713-2809
  • Fax:
Mailing address:
  • Phone: 661-713-2809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95041054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: