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NPI Code Detail

MEDICARE: MRS. AMANDA LYNN ENGELDRUM-MAGANA

MEDICARE:  MRS. AMANDA LYNN ENGELDRUM-MAGANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
21041C0700XClinical Social WorkerLCSW110773CA

General Provider Information

NPI Number : 1285903203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA LYNN ENGELDRUM-MAGANA
Provider Business Mailing Address
First Line : 411 E LAKE AVE
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-4424
Country : US
Telephone Number : 831-728-6445
Fax Number : 831-724-4251
Provider Business Practice Location Address
First Line : 411 E LAKE AVE
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-4424
Country : US
Telephone Number : 831-728-6445
Fax Number : 831-724-4251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2011
Last Update Date : 10/20/2022

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Directions to “ MRS. AMANDA LYNN ENGELDRUM-MAGANA ” Practice Location

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