Amanda L Prince, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

128265 Issued in CA

Practice address

250 Canyon Rd
Newbury Park, CA 91320-4608

Phone

(310) 867-3072

NPI assigned

Sep 6, 2023

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Circle of Life Counseling Center

  • Marriage & Family Therapist
  • Thousand Oaks, CA
  • NPI 1568912541
  Medicare reassignment NPD

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1336925155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CANYON RD",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204608",
            "telephone_number": "310-867-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CANYON RD",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204608",
            "telephone_number": "310-867-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne L Pollock, D.C.
• Milena Popovic, PT, DPT
• Tammy Elizabeth Prado, FNP-C
• Prestige Medical Associates, Inc.
• Lorraine Priceman, M.S. CCC-SLP
• John Hayden Pryor
• Bobbie E Quigley, M.S, M.A
• Corrin Michelle Rakowski, MS, CTRS
• Ralphs Grocery Company (Ralphs Pharmacy)
• Ramin Mehdian Medical Corporation

• Marriage & Family Therapist in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.