Most Relevant Information
Provider Data
| NPI Number: | 1003454414 |
| Provider Name: | AMANDA JANE DE WOLF |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/16/2019 |
| Last Updated: | 12/16/2019 |
Provider Practice Location
66 HURLBUT ST
PASADENA
CA
911054025
Practice Location Phone/Fax
| Phone: | 6264414221 |
| Fax: |
Provider Mailing Location
3474 CANYON RIDGE DR
ALTADENA
CA
910013724
Provider Mailing Phone/Fax
| Phone: | 6263901803 |
| Fax: |