Provider Demographics
NPI:1619200854
Name:ROBINSON, AMANDA (CNA,CHHA,,RCFE,GERO)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CNA,CHHA,,RCFE,GERO
Other - Prefix:MS
Other - First Name:MONDA
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3903
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944
Mailing Address - Country:US
Mailing Address - Phone:619-871-0521
Mailing Address - Fax:
Practice Address - Street 1:4800 NEBO DR
Practice Address - Street 2:# 3903
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3824
Practice Address - Country:US
Practice Address - Phone:619-871-0521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000000000000000163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator