Individual
AMANDA DORA BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92350-1716
(626) 905-1569
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92350-1716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95065011
CA
163WC0200X
Critical Care Medicine Registered Nurse
95065011
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002484
CA
Other
Enumeration date
07/31/2023
Last updated
04/09/2025
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