Individual
AMANDA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4731 CLAIREMONT DR UNIT 100, SAN DIEGO, CA 92117-2743
(858) 272-9564
Mailing address
4269 AVATI DR, SAN DIEGO, CA 92117-4408
(504) 460-1540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95012331
CA
Other
Enumeration date
08/03/2019
Last updated
08/03/2019
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