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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497159461 | NPPES |
| Oregon | MEDICAID | 500679588 |
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