Individual
AMANDA WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
1375 BLOSSOM HILL RD, SUITE 49, SAN JOSE, CA 95118-3806
(408) 758-5650
Mailing address
1375 BLOSSOM HILL RD, SUITE 49, SAN JOSE, CA 95118-3806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95005725
CA
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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