Healthcare Provider Details

I. General information

NPI: 1902074230
Provider Name (Legal Business Name): AMANDA ANNE HUTTON PARROTT RN, DPT, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA ANNE PARROTT RN, DPT

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVENUE BOX 0378 ROOM A422
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

400 PARNASSUS AVENUE BOX 0378 ROOM A422
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2463
  • Fax: 415-353-2406
Mailing address:
  • Phone: 415-353-2463
  • Fax: 415-353-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number663978
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number26981
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number17508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: