MEDICARE: DR. ANDREA SUE AMES PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	27691	CA

General Provider Information

NPI Number	:	1740416841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA SUE AMES PSYD

Provider Business Mailing Address
First Line	:	4000 INNOVATOR DR UNIT 35106
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-3894
Country	:	US
Telephone Number	:	707-334-0290
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 INNOVATOR DR UNIT 35106
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-3894
Country	:	US
Telephone Number	:	707-334-0290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2009
Last Update Date	:	10/01/2024

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