Healthcare Provider Details

I. General information

NPI: 1528159126
Provider Name (Legal Business Name): AMANDA SAXE RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SAXE RN, NP

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32605 TEMECULA PKWY STE 202
TEMECULA CA
92592-6838
US

IV. Provider business mailing address

PO BOX 609001
SAN DIEGO CA
92160-9001
US

V. Phone/Fax

Practice location:
  • Phone: 858-427-5060
  • Fax: 619-383-6701
Mailing address:
  • Phone: 619-528-4600
  • Fax: 619-528-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN612822
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberNP16529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: