Individual
AMANDA CORTLYNE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3148 BELVEDERE DR, RIVERSIDE, CA 92507-3205
(951) 850-9745
Mailing address
3140 BELVEDERE DR, RIVERSIDE, CA 92507-3205
(951) 866-3410
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1234700
DRIVER LICENSE
CA
Enumeration date
01/24/2022
Last updated
01/24/2022
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