Individual
AMANDA LEIGH HERNANDEZ RENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RCP RRT-NPS
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5427
Mailing address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5427
Taxonomy
Speciality
Code
Description
License number
State
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
29146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111965
NATIONAL BOARD OF RESPIRATORY CARE RRT-NPS
—
01
—
29146
STATE RESPIRATORY CARE PRACTITIONER LICENSE
CA
Enumeration date
12/06/2018
Last updated
12/06/2018
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