Active NPI
Amanda Renee Crow, PA-C
- Physician Assistant
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA64520
- Practice address
- 3900 5TH Ave Ste 110
San Diego, CA 92103-3122 - Phone
- (858) 554-1212
- Fax
- (858) 795-1195
- NPI assigned
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA64520 | CA | Primary |
| Physician Assistant | 363A00000X | 08390 | NC |
Addresses
Primary practice location
3900 5TH Ave Ste 110
San Diego, CA 92103-3122
Mailing address
3900 5TH Ave Ste 110
San Diego, CA 92103-3122
Phone (858) 554-1212
Other names 1
- Amanda Renee Harrison
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855
3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA64520 | CA | MD | Physician Assistant |
| 08390 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Horizons Center Inc | Current | Accepting new patients | |
| Coastal Horizons Center, Inc. | Current | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients | |
| UC San Diego Health - Rancho Family Medical Group | Past | Accepting new patients |
Locations
120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515
615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- La Jolla, CA
- NPI 1134309305
-
- Community/Behavioral Health Agency
- Wilmington, NC
- NPI 1922022607
-
- Community/Behavioral Health Agency
- Rocky Point, NC
- NPI 1063082592
-
- Community/Behavioral Health Agency
- Wilmington, NC
- NPI 1790985448
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
- Multi-Specialty Clinic/Center
- Temecula, CA
- NPI 1003385071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1275013526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 5TH AVE STE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033122",
"telephone_number": "858-554-1212",
"fax_number": "858-795-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 5TH AVE STE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033122",
"telephone_number": "858-554-1212",
"fax_number": "858-795-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROW",
"first_name": "AMANDA",
"middle_name": "RENEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA64520",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "08390",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "HARRISON",
"middle_name": "RENEE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.