Provider Demographics
NPI:1124340211
Name:ARAKELYAN, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ARAKELYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6295 CAVAN DR
Mailing Address - Street 2:#3
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-5224
Mailing Address - Country:US
Mailing Address - Phone:916-432-0931
Mailing Address - Fax:
Practice Address - Street 1:6295 CAVAN DR
Practice Address - Street 2:#3
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-5224
Practice Address - Country:US
Practice Address - Phone:916-432-0931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB9463857343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle