=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003776410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA THOMAS-HARRIS AMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2025
-----------------------------------------------------
Last Update Date | 11/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2271 ALPINE BLVD STE A
-----------------------------------------------------
City | ALPINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91901-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-688-0248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 469 E BRADLEY AVE UNIT 7
-----------------------------------------------------
City | EL CAJON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92021-3067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-621-3481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 149087
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------