Individual provider Active NPI

Amanda Ries, M.D.

  • Psychosomatic Medicine Physician
  • San Diego, CA
National Provider Identifier
1417362161
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
A138918 Issued in CA
Practice address
34800 Bob Wilson Dr
San Diego, CA 92134-5004
Phone
(619) 723-1571
Fax
(858) 203-0583
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A138918 CA
Student in an Organized Health Care Education/Training Program 390200000X
Psychosomatic Medicine Physician 2084P0015X A138918 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
San Diego, CA 92134-5004

Mailing address

34800 Bob Wilson Dr San Diego
San Diego, CA 92134-0001

Other practice location 1

9500 Gilman Dr
#9116A
LA Jolla, CA 92093-5004
Phone (858) 534-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
138918CAMDMarriage & Family Therapist
A138918CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucsd Student in an Organized Health Care Education/Training Program Past Accepting new patients
UC San Diego Health Past Accepting new patients

Organizations & group practices 2

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1417362161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR SAN DIEGO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "fax_number": "858-203-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345004",
            "telephone_number": "619-723-1571",
            "fax_number": "858-203-0583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Gilman Dr",
            "address_2": "#9116A",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920935004",
            "country_code": "US",
            "telephone_number": "858-534-4040",
            "fax_number": "858-822-0231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIES",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A138918",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "CA",
            "license": "A138918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.