Provider Demographics
NPI:1477095529
Name:BROWN, AMBER QUIROGA (RN)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:QUIROGA
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W BROADWAY
Mailing Address - Street 2:# 1796
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92815-2000
Mailing Address - Country:US
Mailing Address - Phone:949-546-9473
Mailing Address - Fax:
Practice Address - Street 1:333 W BROADWAY
Practice Address - Street 2:# 1796
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92815-2000
Practice Address - Country:US
Practice Address - Phone:949-546-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025590163WC0400X, 163WG0600X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health