Provider Demographics
NPI:1215066469
Name:YODER, AMANDIP PATARIA
Entity type:Individual
Prefix:MRS
First Name:AMANDIP
Middle Name:PATARIA
Last Name:YODER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AMANDIP
Other - Middle Name:
Other - Last Name:PATARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-0712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:608 10TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-0712
Practice Address - Country:US
Practice Address - Phone:916-441-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator