DR. AMANDA LY (NPI# 1902413495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902413495 |
| Entity Type | Individual |
| Full Name | DR. AMANDA LY |
| Credential | OD |
| Practice Address |
3164 Highlander Rd Fullerton CA 92833-5508 |
| Practice Telephone | 7145152571 |
| Mailing Telephone | 7145152571 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | OPT34702-TLG | CA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417410374 | Amanda Ly | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-9055 | 2019-04-08 |
| 1770047599 | Amanda Ly | Behavior Technician | 1401 Parkmoor Ave Ste 110, San Jose, CA 95126-3453 | 2019-01-25 |
| 1417443334 | Amanda Van Ly | Surgery | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2018-07-03 |
| 1023563145 | Amanda Annie Ly | Marriage & Family Therapist | 1000 E Walnut St Ste 225, Pasadena, CA 91106-1434 | 2016-08-18 |
| 1194091512 | Amanda Dahir Ly | Counselor | 2018 156th Ave Ne, Suite 100, Bellevue, WA 98007-3825 | 2012-03-29 |
| Street Address |
3164 HIGHLANDER RD |
| City | FULLERTON |
| State | CA |
| Zip Code | 92833-5508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333565 | Qz Enterpprises Corp | In Home Supportive Care | 2817 Muir Trail Dr, Fullerton, CA 92833 | 2019-08-26 |
| 1780114306 | Acupuncture Nara Inc | Clinic/Center | 2334 W. Valencia Dr., Fullerton, CA 92833 | 2017-06-15 |
| 1518350149 | Young A Lee | Nurse Practitioner | 2529 Monterey Pl, Fullerton, CA 92833 | 2015-03-06 |
| 1538557871 | Annacess Arcadio | Occupational Therapy Assistant | 1437 W Woodcrest Ave, Fullerton, CA 92833 | 2015-01-08 |
| 1710306923 | Nora Edith Heredia | Counselor | 1060 S Brookhurst Road, Fullerton, CA 92833 | 2014-04-15 |
| 1912322892 | Louis Michael Hinzo | Counselor | 1060 S. Brookhurst Rd., Fullerton, CA 92833 | 2014-02-28 |
| 1497011290 | Paul Choong Hwan Lee, M.d. A Medical Corporation | Ophthalmology | 1401 S. Brookhurst Rd., Suite 107, Fullerton, CA 92833 | 2012-04-05 |
| 1992073860 | Tammy Phan | Pharmacist | 1826 W Orangethrope Ave, Fullerton, CA 92833 | 2011-12-07 |
| 1346577160 | Hara Orthotics and Prosthetics,inc | Prosthetic/Orthotic Supplier | 1343 W. Valencia Dr., Suite E, Fullerton, CA 92833 | 2009-11-16 |
| 1265669923 | Marcelle Bonneau Taylor | Marriage & Family Therapist | 1145 W. Valencia Mesa, Emmanuel Episcopal Church, Fullerton, CA 92833 | 2009-06-19 |
| Find all providers in zip 92833 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366054090 | Rebecca Ramos | Student in an Organized Health Care Education/Training Program | 1235 N Harbor Blvd Ste 115, Fullerton, CA 92832-1323 | 2020-08-24 |
| 1891316584 | Deysi Mejia Mercado | Student in an Organized Health Care Education/Training Program | 126 W Whiting Ave Apt 2, Fullerton, CA 92832-1447 | 2020-05-04 |
| 1205466786 | Zachary Geeseok Oh | Student in an Organized Health Care Education/Training Program | 2012 Brooke Ln, Fullerton, CA 92833-1245 | 2020-01-23 |
| 1841770757 | Brenda Flores | Student in an Organized Health Care Education/Training Program | 801 E. Chapman Ave.,#203, Fullerton, CA 92831-3839 | 2018-08-20 |
| 1639673338 | Arvin Raj Wali | Student in an Organized Health Care Education/Training Program | 2050 Pioneer Ave, Fullerton, CA 92831-1230 | 2018-03-19 |
| 1578078960 | Jae Hee Kim | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 106, Fullerton, CA 92831-3846 | 2017-12-06 |
| 1528584166 | Kristen Goetz | Student in an Organized Health Care Education/Training Program | 309 N Mountain View Pl Apt 9, Fullerton, CA 92831-4168 | 2017-08-16 |
| 1548785058 | Roland Garcia | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave., 203, Fullerton, CA 92831-3839 | 2017-08-04 |
| 1093241911 | Michael Mosier | Student in an Organized Health Care Education/Training Program | 860 Rancho Cir, Fullerton, CA 92835-3335 | 2017-05-11 |
| 1023541646 | Tyler Fong | Student in an Organized Health Care Education/Training Program | 580 Catalina Rd, Fullerton, CA 92835-2419 | 2017-04-10 |
| Find all providers in FULLERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.