Individual
AMANDA MARIE DALIA HAZELTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, MS, AGACNP-BC
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(800) 826-4673
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95027398
CA
363L00000X
Nurse Practitioner
RN2346236
MA
363LA2100X
Acute Care Nurse Practitioner
95027398
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
NP95027398
CA
Other
Enumeration date
10/14/2022
Last updated
11/24/2025
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