Individual
AMANDA ROSE FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNAP, CRNA
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-7326
(858) 249-6748
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95002372
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148969
NBCRNA CERTIFICATION
—
01
—
95002372
CALIFORNIA BOARD OF NURSING CRNA LICENSE
CA
01
—
95231483
CALIFORNIA BOARD OF NURSING RN LICENSE
CA
Enumeration date
06/06/2024
Last updated
07/23/2024
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