Provider Demographics
NPI:1013435783
Name:ADEN, AMANDA (PA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ADEN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1043 W CIVIC CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1043 W CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2379
Practice Address - Country:US
Practice Address - Phone:949-401-2014
Practice Address - Fax:949-393-6286
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA54796363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant