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General NPI Number Information
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NPI Number | 1104474493
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Entity Type | Individual
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Provider Name | ASHLEY RACHAEL AMUNDSON PCCI
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 2912 MANAGUA PL
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City | CARLSBAD
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State | CA
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Zip | 92009-7105
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Country | US
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Telephone | 619-993-8829
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Fax | 760-683-5152
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Provider Business Mailing Address
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Address Line | 6780 FRIARS RD UNIT 322
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City | SAN DIEGO
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State | CA
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Zip | 92108-1192
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Country | US
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Telephone | 619-993-8829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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