Provider Demographics
NPI:1699305649
Name:LINK, AMBER ROSE
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:ROSE
Last Name:LINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:THURLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1872 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-3344
Mailing Address - Country:US
Mailing Address - Phone:626-755-4019
Mailing Address - Fax:
Practice Address - Street 1:411 CAMINO DEL RIO S STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3508
Practice Address - Country:US
Practice Address - Phone:215-918-9311
Practice Address - Fax:800-878-5497
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician