Active NPI
Amanda Camarillo
- Mental Health Counselor
- Berkeley, CA
National Provider Identifier
1275923997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151 - Phone
- (510) 900-7140
- NPI assigned
- Feb 3, 2015
- Reactivated
- Mar 11, 2022
- 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 | Primary |
Addresses
Primary practice location
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Mailing address
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Other practice location 1
5284 Adolfo Rd Ste 100
Camarillo, CA 93012-6790
Phone (805) 289-0120
Other practice location 2
105 N Lincoln St
Santa Maria, CA 93458-4319
Phone (805) 928-1707
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspira Foster & Family Services - Ventura | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Camarillo, CA
- NPI 1215071899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1275923997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 TELEGRAPH AVE STE 515",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2855 TELEGRAPH AVE STE 515",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051151",
"telephone_number": "510-900-7140"
}
],
"practiceLocations": [
{
"address_1": "5284 Adolfo Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Camarillo",
"state": "CA",
"postal_code": "930126790",
"country_code": "US",
"telephone_number": "805-289-0120",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 N Lincoln St",
"address_purpose": "LOCATION",
"city": "Santa Maria",
"state": "CA",
"postal_code": "934584319",
"country_code": "US",
"telephone_number": "805-928-1707",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAMARILLO",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2022-03-15",
"certification_date": "2022-03-15",
"deactivation_date": "2022-02-24",
"reactivation_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.