Amanda Grace Lazo Qaqish, LMFT, PPS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

102948 Issued in CA

Practice address

26087 Arroyo LN
Loma Linda, CA 92354-6520

Phone

(626) 827-2218

NPI assigned

Dec 29, 2014

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Silver Lake Psychology Inc.

  • Psychologist
  • Los Angeles, CA
  • NPI 1932651817
  Medicare reassignment

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1972991958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26087 ARROYO LN",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546520",
            "telephone_number": "626-827-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26087 ARROYO LN",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546520",
            "telephone_number": "626-827-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAQISH",
        "first_name": "AMANDA GRACE",
        "middle_name": "LAZO",
        "credential": "LMFT, PPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarissa Bussell Purkeypile, DNP
• Dylan Purkiss, DO
• Brandon Lee Hiro Putra
• Nicholas Putrasahan
• Imazul Qadir, MD
• Hiba Ali Qasqas, PHARM.D.
• Jerry Z. Qi, M.D.
• Rachel Chu Qian
• Alexander Qin, MD
• Jiantong Qin

• Marriage & Family Therapist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.