Provider Demographics
NPI:1194073692
Name:AMUNDSON, JOY L (NP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:L
Last Name:AMUNDSON
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2151 N HARBOR BLVD STE 2100
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3824
Mailing Address - Country:US
Mailing Address - Phone:714-732-0592
Mailing Address - Fax:714-992-3037
Practice Address - Street 1:2151 N HARBOR BLVD STE 2100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-732-0592
Practice Address - Fax:714-992-3037
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI5237363L00000X
WI150397363L00000X
IL277003877363LA2100X
CA95004766363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care