Provider Demographics
NPI:1780740332
Name:INOUYE, AMY (NP)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:
Last Name:INOUYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 YGNACIO VALLEY RD STE 108
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3100
Mailing Address - Country:US
Mailing Address - Phone:925-932-0390
Mailing Address - Fax:925-932-0370
Practice Address - Street 1:1776 YGNACIO VALLEY RD STE 108
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3100
Practice Address - Country:US
Practice Address - Phone:925-932-0390
Practice Address - Fax:925-932-0370
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12015363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12015OtherMEDICAL LICENSE