Active NPI
Amanda Malka
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1235612847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- AMFT145156
- Practice address
- 1925 Eulid Ave Ste 108
San Diego, CA 92105 - Phone
- (619) 648-1158
- NPI assigned
- Sep 10, 2018
- Last updated
- Feb 29, 2024
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | AMFT145156 | CA | Primary |
Addresses
Primary practice location
1925 Eulid Ave Ste 108
San Diego, CA 92105
Mailing address
8690 Aero Dr. Ste 115
1144
San Diego, CA 92123
Phone (760) 391-3449
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 |
|---|---|---|---|
| AMFT145156 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1235612847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8690 AERO DR. STE 115",
"address_2": "1144",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "760-391-3449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 EULID AVE STE 108",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92105",
"telephone_number": "619-648-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALKA",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-10",
"last_updated": "2024-02-29",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "AMFT145156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.