Individual provider Active NPI

Amber Rae Shupe, ASSOCIATES DEGREE

  • Clinical Social Worker
  • Palm Springs, CA
National Provider Identifier
1033972773
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
130960 Issued in CA
Practice address
2500 N Palm Canyon Dr
Palm Springs, CA 92262-1868
Phone
(760) 424-5602
Fax
(760) 670-2734
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Clinical Social Worker 1041C0700X 130960 CA Primary

Addresses

Primary practice location

2500 N Palm Canyon Dr
Palm Springs, CA 92262-1868

Mailing address

2500 N Palm Canyon Dr
Palm Springs, CA 92262-1868
Phone (760) 424-5602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
130960CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1033972773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N PALM CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621868",
            "telephone_number": "760-424-5602",
            "fax_number": "760-670-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N PALM CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621868",
            "telephone_number": "760-424-5602",
            "fax_number": "760-670-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "AMBER",
        "middle_name": "RAE",
        "credential": "ASSOCIATES DEGREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "130960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.