Amanda Avalos

Individual provider Active NPI Athletic Trainer · La Verne, CA

NPI 1184250052 · NPPES record last updated Mar 23, 2020

Key facts

NPI
1184250052
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
1950 3Rd St
La Verne, CA 91750-4401
Phone
(626) 279-1867
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

1950 3Rd St
La Verne, CA 91750-4401

Mailing address

1950 3Rd St
La Verne, CA 91750-4401

Other providers in La Verne, CA

All providers in La Verne, CA · Athletic Trainer in California

Sources for this page

Verify at the official NPI Registry.