Healthcare Provider Details

I. General information

NPI: 1720942980
Provider Name (Legal Business Name): AMANDA MARIE SALCIDO THOMASON-WEIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31175 PLEASANT VALLEY RD
MENIFEE CA
92584-9175
US

IV. Provider business mailing address

31175 PLEASANT VALLEY RD
MENIFEE CA
92584-9175
US

V. Phone/Fax

Practice location:
  • Phone: 951-312-9412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number47283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: