Individual provider Active NPI

Amanda Colleen Fink, OTR/L

  • Specialist
  • San Clemente, CA
National Provider Identifier
1275814378
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12129 Issued in CA
Practice address
1120 Via Callejon Ste B
San Clemente, CA 92673-6264
Phone
(949) 498-5100
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12129 CA Primary

Addresses

Primary practice location

1120 Via Callejon Ste B
San Clemente, CA 92673-6264

Mailing address

1120 Via Callejon
Suite B
San Clemente, CA 92673-6213
Phone (949) 498-5200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1275814378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 VIA CALLEJON",
            "address_2": "SUITE B",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736213",
            "telephone_number": "949-498-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 VIA CALLEJON STE B",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736264",
            "telephone_number": "949-498-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "AMANDA",
        "middle_name": "COLLEEN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "12129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.