Amanda M Wilbur

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW99373 Issued in CA

Practice address

6840 Indiana Ave Ste 275
Riverside, CA 92506-4279

Phone

(951) 788-0230

NPI assigned

May 27, 2021

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

Other identifiers 1

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1659947984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 RECHE CANYON RD UNIT SP85",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923249570",
            "telephone_number": "951-285-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 INDIANA AVE STE 275",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064279",
            "telephone_number": "951-788-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19321 Grove Community Dr",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925088113",
            "country_code": "US",
            "telephone_number": "951-571-9096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILBUR",
        "first_name": "AMANDA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW99373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE",
            "identifier": "00000000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juanita Wielenga, CNM
• Jill Wieseler
• Mark Wight, AMFT
• Kylie Rose Wilborn
• Quinteria Wilborn
• Brianna Elizabeth Wilcox-Mitchell
• Jacqueline L Wilcoxson, PH.D, LMFT
• Rachel Marie Wilderman
• William Wilensky, LCSW
• Brock S Wiley, DO

• Clinical Social Worker in Riverside, CA
• Providers in Riverside, 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 May 27, 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.