Individual provider Active NPI

Amanda Dawn Patterson, ASW

  • Social Worker
  • Roseville, CA
National Provider Identifier
1073071825
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
85024 Issued in CA
Practice address
2 Medical Plaza Dr
Roseville, CA 95661-3043
Phone
(916) 773-8711
NPI assigned
Mar 11, 2019
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 85024 CA Primary
Clinical Social Worker 1041C0700X ASW85024 CA

Addresses

Primary practice location

2 Medical Plaza Dr
Roseville, CA 95661-3043

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

8912 Volunteer Ln
Sacramento, CA 95826
Phone (916) 662-0426

Other practice location 2

2143 Hurley Way Suite
Suite 240
Sacramento, CA 95825-9582
Phone (916) 440-0089 ext. 202

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
I20230206001592 CA Practitioner - Clinical Social Worker 7719359496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85024CAMDSocial Worker
ASW85024CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Sunburst Projects Current Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients

Locations

2 Medical Plaza Dr
Ste 205
Roseville, CA 95661
Phone (916) 773-8711

2143 Hurley Way
Ste 240
Sacramento, CA 95825
Phone 9164400089 ext. 202

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1073071825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PLAZA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613043",
            "telephone_number": "916-773-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8912 Volunteer Ln",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95826",
            "country_code": "US",
            "telephone_number": "916-662-0426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2143 Hurley Way Suite",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958259582",
            "country_code": "US",
            "telephone_number": "916-440-0089 x202",
            "fax_number": "926-440-1208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "85024",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW85024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.