Individual provider Active NPI

Amanda Marie Larios, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1962289033
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW125555 Issued in CA
Practice address
645 S Minnewawa Ave
Fresno, CA 93727-4141
Phone
(559) 691-6560
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW125555 CA Primary

Addresses

Primary practice location

645 S Minnewawa Ave
Fresno, CA 93727-4141

Mailing address

645 S Minnewawa Ave
Fresno, CA 93727-4141
Phone (559) 691-6560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW125555CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1962289033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S MINNEWAWA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274141",
            "telephone_number": "559-691-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S MINNEWAWA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274141",
            "telephone_number": "559-691-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIOS",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW125555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.