Healthcare Provider Details

I. General information

NPI: 1336349281
Provider Name (Legal Business Name): AMBER LEANN WHEELER CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6240 CLARK RD STE.B
PARADISE CA
95969-4167
US

IV. Provider business mailing address

6240 CLARK RD. STE.B
PARADISE CA
95969
US

V. Phone/Fax

Practice location:
  • Phone: 530-877-4981
  • Fax: 530-877-1048
Mailing address:
  • Phone: 530-877-4981
  • Fax: 530-877-1048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number73171
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: