Active NPI
Amanda Joy
- Social Worker
- Fairfield, CA
National Provider Identifier
1669194684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW128401
- Practice address
- 345 E Travis Blvd
Fairfield, CA 94533-3958 - Phone
- (510) 836-5979
- NPI assigned
- Sep 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| School Social Worker | 1041S0200X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | ASW128401 | CA | Primary |
Addresses
Primary practice location
345 E Travis Blvd
Fairfield, CA 94533-3958
Mailing address
345 E Travis Blvd
Fairfield, CA 94533-3958
Phone (510) 836-5979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW128401 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1669194684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 E TRAVIS BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333958",
"telephone_number": "510-836-5979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 E TRAVIS BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333958",
"telephone_number": "510-836-5979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOY",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-15",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW128401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.