Provider Demographics
NPI:1780606830
Name:BARBER, AMY JENE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JENE
Last Name:BARBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MARGARET LN
Mailing Address - Street 2:SUITE A&B
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-4207
Mailing Address - Country:US
Mailing Address - Phone:530-273-2221
Mailing Address - Fax:530-273-3550
Practice Address - Street 1:101 MARGARET LN
Practice Address - Street 2:SUITE B
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-4207
Practice Address - Country:US
Practice Address - Phone:530-273-2221
Practice Address - Fax:530-273-3550
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17613363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMB1162217OtherDEA