Amanda Amarillas, FNP-C, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Gilbert, AZ
NPI 1831858349 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1831858349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 267547 (AZ)
- Practice address
- 2268 E Williams Field Rd Ste 105
Gilbert, AZ 85295-0757 - Phone
- (480) 878-0081
- NPI assigned
- Dec 12, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240123004921 | AZ | Practitioner - Nurse Practitioner | 7214389485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 267547 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Behavioral Health Services Inc | Current | Accepting new patients | |
| Southwest Behavioral Health Services, Inc. | Current |
Accepting new patients | |
| Southwest Behavioral Health Services, Inc. | Current |
Accepting new patients |
Locations
26428 W US Highway 85
Buckeye, AZ 85326
Phone 6238829906 ext. 3204
404 W Aero Dr
Payson, AZ 85541
Phone (928) 238-3024
2042 N 35th Ave
Phoenix, AZ 85009
Phone (602) 233-0115
3450 N 3rd St
Phoenix, AZ 85012
Phone (602) 257-9339
7600 E Florentine Rd
Ste 201
Prescott Valley, AZ 86314
Phone (928) 775-7088
7600 E Florentine Rd
Ste 101
Prescott Valley, AZ 86314
Phone (928) 775-7088
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 267547 | AZ | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 267547 | AZ | Yes |
Addresses
Primary practice location
2268 E Williams Field Rd Ste 105
Gilbert, AZ 85295-0757
Mailing address
2268 E Williams Field Rd Ste 105
Gilbert, AZ 85295-0757
Phone (480) 878-0081
Other providers in Gilbert, AZ
- Hayder Alyasiri
- Ingrid Amador Mota de Alcantara
- Bethsabe M Amador
- Amanda Overson
- Amani Physical Therapy Services PLLC
- Kelly Amaturo
- Jasmine Amavisca
- Herby Ambroise
- American Care Concepts Gip LLC
- American Care Concepts Hospice LLC
All providers in Gilbert, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.