Provider Demographics
NPI:1184866550
Name:APESOS, AMANDA ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:APESOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 ADELINE ST APT 103
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:730 CAMINO RAMON
Practice Address - Street 2:SUITE 200
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4262
Practice Address - Country:US
Practice Address - Phone:510-289-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor