Provider Demographics
NPI:1396206231
Name:CATANO, AMANDA (RCSN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CATANO
Suffix:
Gender:F
Credentials:RCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3367 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2122
Mailing Address - Country:US
Mailing Address - Phone:951-453-3317
Mailing Address - Fax:951-940-6119
Practice Address - Street 1:975 MORGAN ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-3103
Practice Address - Country:US
Practice Address - Phone:951-940-6100
Practice Address - Fax:951-940-6119
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653195163W00000X
CA150120013163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse