AMANDA GLORIA JEAN CONN (NPI# 1477810182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477810182 |
| Entity Type | Individual |
| Full Name | AMANDA GLORIA JEAN CONN |
| Practice Address |
980 Lincoln Ave Ste 250 San Rafael CA 94901-8802 |
| Mailing Address |
101 South Lake Merced Hills San Francisco CA 94132 |
| Practice Telephone | 4154602167 |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2012-04-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093226581 | Amanda Conn | Psychologist | 454 E Main St Ste 240, Columbus, OH 43215-5380 | 2017-10-24 |
| 1073157889 | Amanda Conn | Physical Therapy Assistant | 5000 Ky Route 321, Prestonsburg, KY 41653-9113 | 2019-11-05 |
| Street Address |
980 LINCOLN AVE STE 250 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-8802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851830483 | Bea Ivory-chambers | Counselor | 1330 Lincoln Ave Ste 202b, San Rafael, CA 94901-2142 | 2017-02-15 |
| 1932559069 | Julia Prentice | Counselor | 920 Cresta Way, #6, San Rafael, CA 94903-5573 | 2016-06-20 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1033528575 | Diane Louise Ray | Counselor | 4 Majorca Ct, San Rafael, CA 94903-1520 | 2014-08-08 |
| 1487072542 | Julie Lehman | Counselor | 1717 5th Ave Ste E, San Rafael, CA 94901-1810 | 2014-04-04 |
| 1073867081 | Lisa Ann Kubiak | Counselor | 900 Mission Ave, San Rafael, CA 94901-6108 | 2012-10-30 |
| 1740530815 | Deborah Ann Spake | Counselor | 712 D St. Suite P, San Rafael, CA 94901 | 2012-09-14 |
| 1386993210 | Sarah Tischler Aikin | Counselor | 555 Northgate Drive, Suite 100, Family Service Agency of Marin, San Rafael, CA 94903-3680 | 2012-09-06 |
| 1558647487 | Katherine O Bregar | Counselor | 361 Third St. Suite G, San Rafael, CA 94901 | 2011-10-24 |
| 1255614889 | Corrissa Madden-grubb | Counselor | 900 Fifth Avenue, Suite 150;, San Rafael, CA 94901 | 2011-09-20 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on AMANDA GLORIA JEAN CONN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.