Individual provider Active NPI

Sally Amaya, LCSW

  • Clinical Social Worker
  • Ontario, CA
National Provider Identifier
1013270719
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
99997 Issued in CA
Practice address
4684 Ontario Mills Pkwy Ste 200
Ontario, CA 91764-5151
Phone
(909) 667-0896
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 99997 CA Primary

Addresses

Primary practice location

4684 Ontario Mills Pkwy Ste 200
Ontario, CA 91764-5151

Mailing address

4684 Ontario Mills Pkwy Ste 200
Ontario, CA 91764-5151
Phone (626) 201-3569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927001547 CA Practitioner - Clinical Social Worker 1456705292 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc Current Accepting new patients
Cyti Health PC CurrentSince Aug 16, 2024 Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Apr 15, 2024 Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Apr 15, 2024 Accepting new patients

Locations

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1013270719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4684 ONTARIO MILLS PKWY STE 200",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645151",
            "telephone_number": "626-201-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4684 ONTARIO MILLS PKWY STE 200",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645151",
            "telephone_number": "909-667-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYA",
        "first_name": "SALLY",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "99997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.