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NPI 1639889983

NPI 1639889983 : AMANDA AHMADI NP : ESCONDIDO, CA

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General NPI Number Information
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    NPI Number           |    1639889983
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA AHMADI NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/28/2022
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    Last Update Date     |    12/12/2024
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Provider Practice Location Address
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    Address Line         |    225 EAST SECOND AVENUE 
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    City                 |    ESCONDIDO
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    State                |    CA
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    Zip                  |    92025
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    Country              |    US
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    Telephone            |    760-291-6700
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    Fax                  |    760-291-6700
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Provider Business Mailing Address
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    Address Line         |    10790 RANCHO BERNARDO RD 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92127-5705
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    Country              |    US
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    Telephone            |    760-806-5700
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    95060232
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    License Number State |    CA
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