Individual provider Active NPI

Amanda Carson

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1235603671
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95035647 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95035647 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 53726
Los Angeles, CA 90074-0001

Other practice location 1

350 Dickinson St Ste 3-325
San Diego, CA 92103-1913
Phone (800) 926-8273

Other practice location 2

4510 Executive Dr
San Diego, CA 92121-3021
Phone (800) 926-8273

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251201003039 CA Practitioner - Nurse Practitioner 1951894773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

File
Suite 53726
Los Angeles, CA 90074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95035647CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Psychiatry CurrentSince Oct 17, 2025 Accepting new 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 Nov 24, 2025 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Nov 24, 2025 Accepting new patients
Regents of the University of California CurrentSince Oct 17, 2025 Accepting new patients

Locations

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

File 53726
Los Angeles, CA 90074

File 57326
Los Angeles, CA 90074

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

350 Dickinson St
Ste 3325
San Diego, CA 92103
Phone (619) 543-5221

4510 Executive Dr
San Diego, CA 92121
Phone (858) 450-5000

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

350 Dickinson St
San Diego, CA 92103
Phone (619) 543-6635

4050 Beyer Blvd
San Ysidro, CA 92173

Interoperability endpoints

  • Direct secure messaging: acarson60404@syhealth.direct-ci.com

Organizations & group practices 5

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1235603671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 53726",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Dickinson St Ste 3-325",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921031913",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4510 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213021",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95035647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.