Individual
AMANDA JEAN ROBERTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 263-2562
Mailing address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 263-2562
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-OMIQZK
CA
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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