Provider Demographics
NPI:1578338422
Name:PALOMARES-SUGDEN, AMANDA R
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:PALOMARES-SUGDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:SUGDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3947 LENNANE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1971
Mailing Address - Country:US
Mailing Address - Phone:916-283-8280
Mailing Address - Fax:916-283-8259
Practice Address - Street 1:3947 LENNANE DR STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1971
Practice Address - Country:US
Practice Address - Phone:916-283-8280
Practice Address - Fax:916-283-8259
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker