Individual provider Active NPI

Amanda Charlotte-Weinland Davis

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1124477153
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW101486 Issued in CA
Practice address
5369 Quail Run Rd Apt 331
Riverside, CA 92507-7738
Phone
(916) 397-7852
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW101486 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

5369 Quail Run Rd Apt 331
Riverside, CA 92507-7738

Mailing address

5369 Quail Run Rd Apt 331
Riverside, CA 92507-7738
Phone (916) 397-7852

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2578 Broadway
Suite 607
New York, NY 10025-7869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW101486CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124477153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5369 QUAIL RUN RD APT 331",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077738",
            "telephone_number": "916-397-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5369 QUAIL RUN RD APT 331",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077738",
            "telephone_number": "916-397-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "middle_name": "CHARLOTTE-WEINLAND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW101486",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.