Active NPI
Amanda Near
- Clinical Social Worker
- Eureka, CA
National Provider Identifier
1215615265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 116748
- Practice address
- 3300 Glenwood St
Eureka, CA 95501-3463 - Phone
- (707) 298-5496
- NPI assigned
- Jul 10, 2023
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 116748 | CA | Primary |
Addresses
Primary practice location
3300 Glenwood St
Eureka, CA 95501-3463
Mailing address
2082 Quaker St Apt G
Eureka, CA 95501-2778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116748 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1215615265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2082 QUAKER ST APT G",
"city": "EUREKA",
"state": "CA",
"postal_code": "955012778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 GLENWOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013463",
"telephone_number": "707-298-5496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAR",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "116748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.