Individual
AMY LYNN DUSENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
332 SANTA FE DR, SUITE 110, ENCINITAS, CA 92024-5143
(760) 943-6700
(760) 632-4292
Mailing address
332 SANTA FE DR, SUITE 110, ENCINITAS, CA 92024-5143
(760) 943-6700
(760) 632-4292
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-0431018
TRI CARE
CA
05
—
GR0093170
—
CA
01
—
ZZZ04918Z
BLUE SHIELD
CA
Enumeration date
10/02/2006
Last updated
01/21/2013
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