Healthcare Provider Details

I. General information

NPI: 1710184122
Provider Name (Legal Business Name): AMBER HOLLINS VOITENKO-AMMERMAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BRYAN AVE STE B
TUSTIN CA
92780-4401
US

IV. Provider business mailing address

1101 BRYAN AVE STE B
TUSTIN CA
92780-4401
US

V. Phone/Fax

Practice location:
  • Phone: 714-730-2225
  • Fax: 714-730-2223
Mailing address:
  • Phone: 714-730-2225
  • Fax: 714-730-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: