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Individual

MISS AMANDA HARTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2640 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704
(510) 981-5290
(510) 981-5265
Mailing address
125 MOSS AVE. APT# 319, OAKLAND, CA 94611
(805) 458-3379

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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