Amsden, Niki Desanto

Amsden, Niki Desanto is an individual health care provider with primary practice located at 2700 Stewart Parkway Annex B, Roseburg OR 97471. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Amsden, Niki Desanto can be contacted via phone (541) 440-3532.

Contact Information

Primary practice address
2700 Stewart Parkway Annex B Roseburg OR 97471
Phone: (541) 440-3532
Fax: (541) 440-3554
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 12507 California
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X 2464 Oregon
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2464 Oregon

Profile Details

NPI number 1497159461
LBN Legal business name Amsden, Niki Desanto
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2014
Last updated Feb 19th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497159461 NPPES
Oregon MEDICAID 500679588

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