Individual provider Active NPI

Amanda Lee Hettema, CNM, WHNP

  • Advanced Practice Midwife
  • Chico, CA
National Provider Identifier
1417778564
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236512 Issued in CA
Practice address
1405 Magnolia Ave
Ste. a
Chico, CA 95926
Phone
(530) 332-5080
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X
Advanced Practice Midwife 367A00000X 236512 CA Primary

Addresses

Primary practice location

1405 Magnolia Ave
Ste. a
Chico, CA 95926

Mailing address

1504 Lupton Ave
San Jose, CA 95125-3848
Phone (408) 218-2311

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250219001367 CA Practitioner - Certified Nurse Midwife (CNM) 0042730210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
236512CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Feb 3, 2025 Accepting new patients
Enloe Medical Center CurrentSince Feb 3, 2025 Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

1665 Esplanade
Chico, CA 95926
Phone (530) 332-5070

1405 Magnolia Ave
#A
Chico, CA 95926
Phone (530) 332-5080

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332

Interoperability endpoints

  • Direct secure messaging: ahettema78484@enloedirect.org

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1417778564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 LUPTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253848",
            "telephone_number": "408-218-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MAGNOLIA AVE",
            "address_2": "STE. A",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926",
            "telephone_number": "530-332-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTEMA",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.