Provider Demographics
NPI:1033850326
Name:AMINI, SANDY
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:AMINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1701
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91376-1701
Mailing Address - Country:US
Mailing Address - Phone:818-917-8894
Mailing Address - Fax:
Practice Address - Street 1:1400 MARKET ST STE 8103
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1050
Practice Address - Country:US
Practice Address - Phone:530-246-5854
Practice Address - Fax:530-242-3892
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program