Healthcare Provider Details

I. General information

NPI: 1518784560
Provider Name (Legal Business Name): AMANDA OROZCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MOTOR AVE
LOS ANGELES CA
90034-3710
US

IV. Provider business mailing address

10008 NATIONAL BLVD # 193
LOS ANGELES CA
90034-3809
US

V. Phone/Fax

Practice location:
  • Phone: 805-991-7288
  • Fax:
Mailing address:
  • Phone: 310-795-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135453
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number92209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: