Provider Demographics
NPI:1356679377
Name:AMANDA P CANTU
Entity Type:Organization
Organization Name:AMANDA P CANTU
Other - Org Name:KERN AMBULETTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-387-9468
Mailing Address - Street 1:6443 ABBY ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-7410
Mailing Address - Country:US
Mailing Address - Phone:661-387-9468
Mailing Address - Fax:661-387-9479
Practice Address - Street 1:6443 ABBY ROSE AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-7410
Practice Address - Country:US
Practice Address - Phone:661-387-9468
Practice Address - Fax:661-387-9479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADP277BA343900000X
CA6VUM693343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)