Provider Demographics
NPI:1215734470
Name:BOBO, AMBER LOUISE COURTNEY
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LOUISE COURTNEY
Last Name:BOBO
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:LOUISE
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 401096
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17508 HERCULES ST STE B6
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-7614
Practice Address - Country:US
Practice Address - Phone:760-488-7971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker