Individual provider Active NPI

Amanda Weaver

  • Marriage & Family Therapist
  • El Cajon, CA
National Provider Identifier
1174266423
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
875 El Cajon Blvd
El Cajon, CA 92020-5714
Phone
(619) 247-3930
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

875 El Cajon Blvd
El Cajon, CA 92020-5714

Mailing address

9303 Woodruff Way
Santee, CA 92071-2977
Phone (619) 247-3930

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
I20240111000677 CA Practitioner - Marriage and Family Therapist 5395196679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

875 El Cajon Blvd
El Cajon, CA 92020
Phone (619) 205-4585

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

Organizations & group practices 3

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1174266423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9303 WOODRUFF WAY",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712977",
            "telephone_number": "619-247-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 EL CAJON BLVD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205714",
            "telephone_number": "619-247-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.