Provider Demographics
NPI:1588970537
Name:NETERER, AMY E (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:NETERER
Suffix:
Gender:F
Credentials:PA-C
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:27472 PORTOLA PKWY
Mailing Address - Street 2:#205-#151
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27472 PORTOLA PKWY
Practice Address - Street 2:SUITE 205-#151
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2853
Practice Address - Country:US
Practice Address - Phone:949-455-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA21129363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical