Healthcare Provider Details

I. General information

NPI: 1962383216
Provider Name (Legal Business Name): AMBER ELAM MSW, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 10/24/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8239 KINGSBRIDGE DR
SACRAMENTO CA
95829-6040
US

IV. Provider business mailing address

5994 LAKE CREST WAY APT 2
SACRAMENTO CA
95822-3321
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-7525
  • Fax:
Mailing address:
  • Phone: 559-779-8467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: