Individual provider Active NPI

Amanda Wilkman, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Manhattan Beach, CA
National Provider Identifier
1326462672
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
22910 Issued in CA
Practice address
1000 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266-5973
Phone
(310) 372-9900
Fax
(310) 372-9901
NPI assigned
Feb 6, 2014
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 22910 CA Primary

Addresses

Primary practice location

1000 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266-5973

Mailing address

1000 N Sepulveda Blvd Ste 210
Manhattan Beach, CA 90266-5973
Phone (310) 372-9900

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

LicenseStateTypeSpecialty
22910CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Wilkman, NP Psychiatric Nursing, Remedium Inc Psychiatric/Mental Health CurrentSince Jun 21, 2020 Accepting new patients

Locations

1000 N Sepulveda Blvd
Ste 210
Manhattan Beach, CA 90266
Phone (310) 372-9900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1326462672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N SEPULVEDA BLVD STE 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665973",
            "telephone_number": "310-372-9900",
            "fax_number": "310-372-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N SEPULVEDA BLVD STE 210",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665973",
            "telephone_number": "310-372-9900",
            "fax_number": "310-372-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKMAN",
        "first_name": "AMANDA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "22910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.