Individual
AMIE JACKELIN VIDANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11562 KNOTT ST STE 17, GARDEN GROVE, CA 92841-1823
(714) 209-7602
Mailing address
11562 KNOTT ST STE 17, GARDEN GROVE, CA 92841-1823
(714) 209-7602
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC37409
CA
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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