Provider Demographics
NPI:1902193501
Name:HEWITT, AMBER JUDITH (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:JUDITH
Last Name:HEWITT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 MASON ST FL 3
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4646
Mailing Address - Country:US
Mailing Address - Phone:707-427-4900
Mailing Address - Fax:707-454-5831
Practice Address - Street 1:770 MASON ST FL 3
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4646
Practice Address - Country:US
Practice Address - Phone:707-427-4900
Practice Address - Fax:707-454-5831
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21911363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant