Individual
AMANDA LYNN CARUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7554 DUBLIN BLVD, DUBLIN, CA 94568-4365
(888) 663-6331
(415) 252-7176
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(415) 658-6791
(415) 520-0904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA56736
STATE MEDICAL LICENSE
CA
Enumeration date
10/03/2018
Last updated
07/18/2024
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