Active NPI
Amanda Stephanie Lee, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1740409432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 74719
- Practice address
- 2208 River Run Dr Unit 56
San Diego, CA 92108-5810 - Phone
- (951) 760-3882
- NPI assigned
- Apr 24, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 74719 | CA | Primary |
Addresses
Primary practice location
2208 River Run Dr Unit 56
San Diego, CA 92108-5810
Mailing address
2208 River Run Dr Unit 56
San Diego, CA 92108-5810
Other practice location 1
5348 University Ave
Suite 101
San Diego, CA 92105-8025
Phone (619) 229-2999 ext. 114
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74719 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Linda Yoon Licensed Clinical Social Worker, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Manhattan Beach, CA
- NPI 1295344372
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1740409432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2208 RIVER RUN DR UNIT 56",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921085810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2208 RIVER RUN DR UNIT 56",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921085810",
"telephone_number": "951-760-3882"
}
],
"practiceLocations": [
{
"address_1": "5348 University Ave",
"address_2": "Suite 101",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921058025",
"country_code": "US",
"telephone_number": "619-229-2999 x114",
"fax_number": "619-229-2998",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "AMANDA",
"middle_name": "STEPHANIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "74719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.