Individual provider Active NPI

Amir Ahmed Siddiqui

  • Counselor
  • Manteca, CA
National Provider Identifier
1336617844
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401017476 Issued in MI
Practice address
1824 Belmont PL
Manteca, CA 95337-8418
Phone
(313) 296-8734
NPI assigned
Nov 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401017476 MI
Mental Health Counselor 101YM0800X 5341 CA
Mental Health Counselor 101YM0800X LPCC10248 CA
Counselor 101Y00000X 6401017476 MI Primary
Counselor 101Y00000X MI

Addresses

Primary practice location

1824 Belmont PL
Manteca, CA 95337-8418

Mailing address

1824 Belmont PL
Manteca, CA 95337-8418
Phone (313) 296-8734

Other practice location 1

35 E 10th St Ste L
Tracy, CA 95376-4083
Phone (313) 296-8734

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
5341CAMDMental Health Counselor
LPCC10248CAMDMental Health Counselor
6401017476MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy With Amir Licensed Professional Clinical Counselor Inc. Mental Health CurrentSince Jul 3, 2022 Accepting new patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients
Toiyabe Indian Health Project, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amirsiddiqui@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1336617844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 BELMONT PL",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378418",
            "telephone_number": "313-296-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 BELMONT PL",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378418",
            "telephone_number": "313-296-8734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 E 10th St Ste L",
            "address_purpose": "LOCATION",
            "city": "Tracy",
            "state": "CA",
            "postal_code": "953764083",
            "country_code": "US",
            "telephone_number": "313-296-8734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AMIR",
        "middle_name": "AHMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017476",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "5341",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC10248",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017476",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.

Verify at the official NPI Registry.