Healthcare Provider Details

I. General information

NPI: 1295642569
Provider Name (Legal Business Name): AMANDA VU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 KUMQUAT WAY
OCEANSIDE CA
92058-1662
US

IV. Provider business mailing address

676 KUMQUAT WAY
OCEANSIDE CA
92058-1662
US

V. Phone/Fax

Practice location:
  • Phone: 303-562-7807
  • Fax:
Mailing address:
  • Phone: 303-562-7807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: