Amanda Elizabeth Clark

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-28708 Issued in CA

Practice address

4505 Las Virgenes Rd Ste 107
Calabasas, CA 91302-1956

Phone

(818) 932-9644

Fax

(818) 932-8997

NPI assigned

Feb 14, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1710487996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 LAS VIRGENES RD STE 107",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 LAS VIRGENES RD STE 107",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021956",
            "telephone_number": "818-932-9644",
            "fax_number": "818-932-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-17-28708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Lynn Christopher, D.C.
• Sally Chu, OD
• James Chung
• Janet Cisneros, RN
• Angelina Yang Ciuffo
• Erica Clark, LVN
• Ann Marie Cleary, LCSW
• Carrie Ann Cleveland, LMFT
• Hannah Cobb, LMFT
• Cohen Healthcare Inc

• Behavior Analyst in Calabasas, CA
• Providers in Calabasas, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.