Provider Demographics
NPI:1982001541
Name:SINATRA, AMY (MT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SINATRA
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 S JUNIPER ST UNIT 48
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6151
Mailing Address - Country:US
Mailing Address - Phone:760-522-1747
Mailing Address - Fax:
Practice Address - Street 1:2055 MONTIEL RD
Practice Address - Street 2:SUITE 109 STUDIO #23
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3562
Practice Address - Country:US
Practice Address - Phone:760-522-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35833225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist