Provider Demographics
NPI:1184852014
Name:AMOS, TORI B (TORI AMOS)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:B
Last Name:AMOS
Suffix:
Gender:F
Credentials:TORI AMOS
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:B
Other - Last Name:AMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TORI AMOS HMT
Mailing Address - Street 1:416 1/2 BRODERICK ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2228
Mailing Address - Country:US
Mailing Address - Phone:415-846-8275
Mailing Address - Fax:
Practice Address - Street 1:3150 18TH ST. #515
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-846-8275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist