Individual
PROF. AMJAD AL-KHAWALDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, CNS, NP
Contact information
Practice address
24953 PASEO DE VALENCIA STE 24A, LAGUNA HILLS, CA 92653-4343
(714) 875-3755
Mailing address
2012 FALLEN LEAF PL, TUSTIN, CA 92780-6713
(714) 875-3755
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
539548
CA
363L00000X
Nurse Practitioner
Primary
95006131
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95006131
NP LICENSE AND FURNISHING NUMBER
CA
Enumeration date
02/09/2017
Last updated
06/01/2026
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