Individual
MS. AMANDA ELYSE TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 346-7655
(760) 346-3037
Mailing address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 346-7655
(760) 346-3037
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95025355
CA
363LF0000X
Family Nurse Practitioner
Primary
95030859
CA
Other
Enumeration date
03/30/2023
Last updated
08/04/2025
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