1013189554 NPI number — AMANDA BALDIZAN NARVAEZ ICADC, CADC-II, MHRS

Table of content: REBEKAH HOPE USKOSKI M.A. (NPI 1073945283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013189554 NPI number — AMANDA BALDIZAN NARVAEZ ICADC, CADC-II, MHRS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NARVAEZ
Provider First Name:
AMANDA
Provider Middle Name:
BALDIZAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ICADC, CADC-II, MHRS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BALDIZAN
Provider Other First Name:
AMANDA
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CADC-II, ICADC, MHRS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013189554
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 77
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRODERICK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95605-0077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-607-4081
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1905 E BEAMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95776-6257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-631-0814
Provider Business Practice Location Address Fax Number:
530-447-1222
Provider Enumeration Date:
03/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225400000X , with the licence number:  A020470815 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: A020470815 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X , with the licence number: A020470815 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)