Individual
AMANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8232
(619) 542-4060
Mailing address
7482 MOHAWK ST, APT 45, LA MESA, CA 91942-7445
(330) 431-1604
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95035582
CA
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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