AMANDA WALL (NPI# 1811520851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811520851 |
| Entity Type | Individual |
| Full Name | AMANDA WALL |
| Practice Address |
3617 Ricardo Ave Apt 1 Redding CA 96002-2653 |
| Mailing Address |
3648 El Portal Dr Redding CA 96002-3133 |
| Practice Telephone | 5307221114 |
| Mailing Telephone | 5307221114 |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053527705 | Amanda Wall | Counselor | 3255 Cahuenga Blvd W, Suite 208, Los Angeles, CA 90068-1375 | 2007-05-16 |
| Street Address |
3617 RICARDO AVE APT 1 |
| City | REDDING |
| State | CA |
| Zip Code | 96002-2653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053667881 | Tonya Brissey | Counselor | 3617 Ricardo Ave Apt 1, Redding, CA 96002-2653 | 2012-07-30 |
| 1497388391 | David Neely | Counselor | 3617 Ricardo Ave Apt 1, Redding, CA 96002-2653 | 2020-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048037 | Daniel Eli Bartee | Counselor | 555 Leila Ave #44, Redding, CA 96002 | 2020-09-17 |
| 1407467129 | Drake Exstrom | Dentist | 2315 North Bechelli Ln, Suite A, Redding, CA 96002 | 2020-08-14 |
| 1285123117 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20846 Clairvaux Drive, Redding, CA 96002 | 2018-05-07 |
| 1528510153 | Daniel Conklin | Pharmacist | 2880 Churn Creek, Redding, CA 96002 | 2016-10-31 |
| 1740653864 | Votc, Inc. | Substance Abuse Rehabilitation Facility | 3590 El Portal Dr., # 7, 8, 9, 10, 15, 16, & 17, Redding, CA 96002 | 2015-11-11 |
| 1801226253 | Katie Marie Mccullough-stubbs | Marriage & Family Therapist | 3300 Church Creek, Redding, CA 96002 | 2013-11-21 |
| 1801234026 | Kathy Lynne Hawk | Community Health Worker | 2051 Hilltop Dr A-13, Redding, CA 96002 | 2013-06-10 |
| 1619247590 | Wright Education Services | Social Worker | 2660 Victor Ave, Redding, CA 96002 | 2012-01-09 |
| 1275828840 | Shannika Tricia Dao | Dentist | 2695 Bechelli Ln, Redding, CA 96002 | 2011-06-13 |
| 1336442664 | Small Talk Pediatric Services, Inc. | Speech-Language Pathologist | 2526 Goodwater Ave., Suite A, Redding, CA 96002 | 2010-12-08 |
| Find all providers in zip 96002 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048037 | Daniel Eli Bartee | Counselor | 555 Leila Ave #44, Redding, CA 96002 | 2020-09-17 |
| 1952922924 | Barbara Jessup | Counselor | 6970 Westside Rd, Redding, CA 96001-5222 | 2020-05-01 |
| 1114548393 | David M Cloyes | Counselor | 3590 El Portal Dr Apt 15, Redding, CA 96002-3154 | 2020-04-29 |
| 1144853177 | Michelle Lillian Marshall | Counselor | 3617 Ricardo Ave, Redding, CA 96002-2653 | 2020-02-18 |
| 1093348369 | Steven Earl Keck | Counselor | 3600 Ricardo Ave, Redding, CA 96002-2649 | 2020-02-14 |
| 1902439300 | Paul Miranda | Counselor | 2532 Wilson Ave Apt D, Redding, CA 96002-1741 | 2020-02-13 |
| 1609333616 | William Todd Napp | Counselor | 1145 Hartnell Ave, Redding, CA 96002-2113 | 2019-02-26 |
| 1427486356 | Laurinda Gifford | Counselor | 1147 Hartnell Ave, Redding, CA 96002-2113 | 2013-11-01 |
| 1801136882 | Tamara L Stein | Counselor | 3648 El Portal Dr, Redding, CA 96002-3133 | 2013-02-27 |
| 1568713659 | Ashley Elaine Ellis | Counselor | 3570 Santa Rosa Way, Redding, CA 96003-1766 | 2012-09-28 |
| Find all providers in REDDING | ||||
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| 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.