Active NPI
Samantha Marie Amezcua
- Peer Specialist
- Long Beach, CA
National Provider Identifier
1861367542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-QTHDYJ
- Practice address
- 2101 Magnolia Ave
Long Beach, CA 90806-4521 - Phone
- (562) 218-1868
- NPI assigned
- Oct 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-QTHDYJ | CA | Primary |
Addresses
Primary practice location
2101 Magnolia Ave
Long Beach, CA 90806-4521
Mailing address
863 N Vail Ave
Montebello, CA 90640-2432
Phone (323) 770-5452
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 |
|---|---|---|---|
| MPSS-QTHDYJ | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1861367542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "863 N VAIL AVE",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906402432",
"telephone_number": "323-770-5452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 MAGNOLIA AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908064521",
"telephone_number": "562-218-1868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEZCUA",
"first_name": "SAMANTHA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-10",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-QTHDYJ",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.