Provider Demographics
NPI:1669067799
Name:ALWARD, AMY RENEE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:ALWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96093-0158
Mailing Address - Country:US
Mailing Address - Phone:530-623-1204
Mailing Address - Fax:530-623-1237
Practice Address - Street 1:333 TOM BELL RD
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093
Practice Address - Country:US
Practice Address - Phone:530-623-1204
Practice Address - Fax:530-623-1237
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator