Provider Demographics
NPI:1790066488
Name:SEMRAU, AMANDA LORAINE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LORAINE
Last Name:SEMRAU
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:25982 PALA, SUITE 180
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-600-8990
Mailing Address - Fax:949-600-8998
Practice Address - Street 1:25982 PALA
Practice Address - Street 2:SUITE 180
Practice Address - City:MISION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-600-8990
Practice Address - Fax:949-600-8998
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant