Individual provider Active NPI

Amanda Speedy

  • Marriage & Family Therapist
  • Redwood City, CA
National Provider Identifier
1760291157
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147094 Issued in CA
Practice address
611 Veterans Blvd Ste 102
Redwood City, CA 94063-1462
Phone
(415) 448-7004
NPI assigned
Dec 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 147094 CA Primary

Addresses

Primary practice location

611 Veterans Blvd Ste 102
Redwood City, CA 94063-1462

Mailing address

611 Veterans Blvd Ste 102
Redwood City, CA 94063-1462
Phone (415) 448-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 17, 2025 through Nov 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
147094CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1760291157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 VETERANS BLVD STE 102",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631462",
            "telephone_number": "415-448-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 VETERANS BLVD STE 102",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631462",
            "telephone_number": "415-448-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEEDY",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.