Healthcare Provider Details

I. General information

NPI: 1740072164
Provider Name (Legal Business Name): AMBER GWENDOLYN SRIPAN MSN, APRN, ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10672 WEXFORD ST STE 202
SAN DIEGO CA
92131-3974
US

IV. Provider business mailing address

10672 WEXFORD ST STE 202
SAN DIEGO CA
92131-3974
US

V. Phone/Fax

Practice location:
  • Phone: 858-621-4145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number755499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: