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General NPI Number Information
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NPI Number | 1487426664
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Entity Type | Individual
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Provider Name | ANDREA PACHECO-AMARO
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1025 E BROADWAY RD STE 101
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City | TEMPE
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State | AZ
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Zip | 85282-1535
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Country | US
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Telephone | 626-802-8843
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Fax |
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Provider Business Mailing Address
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Address Line | 505 W BASELINE RD APT 1026
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City | TEMPE
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State | AZ
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Zip | 85283-1173
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Country | US
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Telephone | 626-802-8843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATR-100205
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License Number State | AZ
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