Ambar Jacqueline Green

Primary specialty

Social WorkerTaxonomy code 104100000X

License

103450 Issued in CA

Practice address

4000 W Metropolitan Dr Ste 404
Orange, CA 92868-3504

Phone

(714) 645-8045

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• County of Orange

  • Adolescent and Children Mental Health Clinic/Center
  • Orange, CA
  • NPI 1649716770
  NPD
• County of Orange

  • Adolescent and Children Mental Health Clinic/Center
  • Orange, CA
  • NPI 1477193910
  NPD (past)
• Western Youth Services

  • Adolescent and Children Mental Health Clinic/Center
  • Anaheim, CA
  • NPI 1770617987
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1952766909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 404",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-645-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 404",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-645-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 W Orangewood Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928681980",
            "country_code": "US",
            "telephone_number": "714-456-8040",
            "fax_number": "714-939-2078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "AMBAR",
        "middle_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "103450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicki Gray
• Ronald Gray, MFTI
• Gary James Greco, RPH
• Nicolemadeira Vasconcellos Greco
• Green Haven Home Care
• Brittney Green
• Emelie Green
• Eric Anthony Green
• Geoffrey Riley Green, PA
• Jessica Michelle Green, MD

• Social Worker in Orange, CA
• Providers in Orange, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.