Amanda K Madrid, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101502 Issued in CA

Practice address

12440 E Firestone Blvd
Suite 3020
Norwalk, CA 90650-9331

Phone

(562) 864-7821

NPI assigned

Mar 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Amanda M Kubicek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1427441260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 16TH PL APT C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926279410",
            "telephone_number": "319-360-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 E FIRESTONE BLVD",
            "address_2": "SUITE 3020",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906509331",
            "telephone_number": "562-864-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRID",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "81455",
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "37965",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KUBICEK",
            "middle_name": "M",
            "credential": "ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Ma
• Christine Mac, NP
• Diana Macedo
• Kayley Machado
• Rachelle Sharon Mack, LVN
• Elizabeth Madrigal
• Vanessa Madrigal, MSW
• Anthony Jon Magallanes, LVN
• Maritza Magana
• Hrak Magdesyan

• Clinical Social Worker in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.