Provider Demographics
NPI:1598430076
Name:FRASIER, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:FRASIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14427 MERIDIAN PKWY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92518-3014
Mailing Address - Country:US
Mailing Address - Phone:855-581-0100
Mailing Address - Fax:
Practice Address - Street 1:14427 MERIDIAN PKWY # 7E
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-3014
Practice Address - Country:US
Practice Address - Phone:855-558-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty