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

NPI Number: 1013189554
Health Care Provider/Practitioner: AMANDA BALDIZAN NARVAEZ ICADC, CADC-II, MHRS

NPI Number : 1013189554 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013189554",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NARVAEZ",
    "FirstName": "AMANDA",
    "MiddleName": "BALDIZAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ICADC, CADC-II, MHRS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BALDIZAN",
    "OtherFirstName": "AMANDA",
    "OtherMiddleName": "RAE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "CADC-II, ICADC, MHRS",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 77",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRODERICK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95605-0077",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "916-607-4081",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1905 E BEAMER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WOODLAND",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95776-6257",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "530-631-0814",
    "PracticeLocationAddressFaxNumber": "530-447-1222",
    "EnumerationDate": "03/25/2008",
    "LastUpdateDate": "08/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225400000X",
          "TaxonomyName": "Rehabilitation Practitioner",
          "LicenseNumber": "A020470815",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "A020470815",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": "A020470815",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}