Active NPI
Amanda Marie Chavez
- Counselor
- Valley Center, CA
National Provider Identifier
1144721051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 50100 Golsh Rd
Valley Center, CA 92082-5338 - Phone
- (760) 749-1410
- Fax
- (760) 749-3347
- NPI assigned
- Feb 26, 2018
- Last updated
- Feb 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
50100 Golsh Rd
Valley Center, CA 92082-5338
Mailing address
PO Box 406
Pauma Valley, CA 92061-0406
Phone (760) 749-1410
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240812002667 | CA | Order and Referring Only - Marriage and Family Therapist | 2860930682 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112313 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1144721051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 406",
"city": "PAUMA VALLEY",
"state": "CA",
"postal_code": "920610406",
"telephone_number": "760-749-1410",
"fax_number": "760-749-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50100 GOLSH RD",
"city": "VALLEY CENTER",
"state": "CA",
"postal_code": "920825338",
"telephone_number": "760-749-1410",
"fax_number": "760-749-3347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "AMANDA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Center, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.