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General NPI Number Information
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NPI Number | 1124979323
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Entity Type | Individual
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Provider Name | AMANDA DE JEAN HORN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 7373 UNIVERSITY AVE STE 201
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City | LA MESA
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State | CA
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Zip | 91942-0524
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Country | US
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Telephone | 619-258-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 40106 PEVERO CT
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City | PALMDALE
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State | CA
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Zip | 93551-3609
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW134171
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License Number State | CA
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