Individual
AMANDA M VANDERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
6150 TULE LANE, FORESTHILL, CA 95631
(530) 367-2609
Mailing address
4800 YANKEE JIMS RD, FORESTHILL, CA 95631-9408
(530) 401-4353
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/25/2019
Last updated
08/01/2019
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