Active NPI
Amanda Kathleen Archer
- Rehabilitation Practitioner
- Ukiah, CA
National Provider Identifier
1295129807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 776 S State St Ste 107
Ukiah, CA 95482-5858 - Phone
- (707) 463-4915
- NPI assigned
- Mar 20, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
776 S State St Ste 107
Ukiah, CA 95482-5858
Mailing address
776 S State St Ste 107
Ukiah, CA 95482-5858
Phone (707) 463-4915
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1295129807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "776 S STATE ST STE 107",
"city": "UKIAH",
"state": "CA",
"postal_code": "954825858",
"telephone_number": "707-463-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "776 S STATE ST STE 107",
"city": "UKIAH",
"state": "CA",
"postal_code": "954825858",
"telephone_number": "707-463-4915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "AMANDA",
"middle_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-20",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.