Amelia Vongphairoth

Primary specialty

CounselorTaxonomy code 101Y00000X

License

136249 Issued in CA

Practice address

891 Mountain Ranch Rd
San Andreas, CA 95249-9713

Phone

(209) 754-6464

NPI assigned

Dec 15, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1194593434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 WILLOW CREEK RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499789",
            "telephone_number": "209-890-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499713",
            "telephone_number": "209-754-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGPHAIROTH",
        "first_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "136249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Michael Valentine, MA
• Rita Valladao
• Valley Sleep Disorders Center of San Andreas Medical Group
• John Brian Vandyck, REV.
• Diane Vickerman
• Lisa Voorhees, PH.D.
• Codi N Walker
• Marc Walter, MD
• Paige Elaine Webb, N/A
• Sandy Wells

• Counselor in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.