Amie Mahavanh
Individual provider Active NPI School Counselor · Boulevard, CA
NPI 1831052976 · NPPES record last updated Dec 5, 2025
Key facts
- NPI
- 1831052976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Counselor 101YS0200X
- License
- 240145966 (CA)
- Practice address
- 39639 Old Highway 80
Boulevard, CA 91905-9733 - Phone
- (619) 766-4655
- NPI assigned
- Dec 5, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240145966 | CA | MD | School Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 240145966 | CA | Yes |
Addresses
Primary practice location
39639 Old Highway 80
Boulevard, CA 91905-9733
Mailing address
39639 Old Highway 80
Boulevard, CA 91905-9733
Phone (619) 766-4655
Other providers in Boulevard, CA
- Lisa Anne Harlow
- Tricia Denise Neill
- Serena Angelina Pitula
- Southern Indian Health Council
- Patrick Williamson
All providers in Boulevard, CA · School Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.