Healthcare Provider Details

I. General information

NPI: 1821936220
Provider Name (Legal Business Name): AMANDA STURGIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA MILLER RN

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 MORNING STAR DR
SONORA CA
95370-9249
US

IV. Provider business mailing address

15476 CAMINO DEL PARQUE N
SONORA CA
95370-9618
US

V. Phone/Fax

Practice location:
  • Phone: 209-533-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95405693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: