Active NPI
Amanda C Zybala, LCSW
- Clinical Social Worker
- Walnut, CA
National Provider Identifier
1760739254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 70382
- Practice address
- 20463 Valley Blvd
Walnut, CA 91789-2729 - Phone
- (909) 594-2762
- NPI assigned
- Aug 14, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW33846 | CA | |
| Clinical Social Worker | 1041C0700X | 70382 | CA | Primary |
Addresses
Primary practice location
20463 Valley Blvd
Walnut, CA 91789-2729
Mailing address
213 N Lark Ellen Ave
West Covina, CA 91791-1325
Phone (626) 488-7128
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 |
|---|---|---|---|
| ASW33846 | CA | MD | Mental Health Counselor |
| 70382 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1760739254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 N LARK ELLEN AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917911325",
"telephone_number": "626-488-7128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20463 VALLEY BLVD",
"city": "WALNUT",
"state": "CA",
"postal_code": "917892729",
"telephone_number": "909-594-2762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZYBALA",
"first_name": "AMANDA",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-14",
"last_updated": "2023-06-28",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW33846",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "70382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.