Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2277499 | MA |
NPI | 1033550439 |
---|---|
Provider Name | Amanda Vo |
First Address | Cerritos, CA 90703 |
Second Address | Rancho Cordova, CA 95670-6086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2013 |
Last Update Date | 27/01/2022 |