Active NPI
Amy Mariko Andersson, M.A.
- Contractor
- Banning, CA
National Provider Identifier
1942589569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 245 N Murray St
Banning, CA 92220-5528 - Phone
- (951) 849-8812
- Fax
- (951) 755-8915
- NPI assigned
- Aug 12, 2011
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
245 N Murray St
Banning, CA 92220-5528
Mailing address
245 N Murray St
Banning, CA 92220-5528
Phone (951) 849-8812
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Home Support Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Banning, CA
- NPI 1578893699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313107200000",
"number": "1942589569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 N MURRAY ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922205528",
"telephone_number": "951-849-8812",
"fax_number": "951-755-8915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 N MURRAY ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922205528",
"telephone_number": "951-849-8812",
"fax_number": "951-755-8915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSSON",
"first_name": "AMY",
"middle_name": "MARIKO",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2011-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.