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General NPI Number Information
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NPI Number | 1164943700
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Entity Type | Individual
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Provider Name | AMBER MARIE WESTPHAL
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 6302 13TH AVENUE
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City | LUCERNE
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State | CA
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Zip | 95458
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Country | US
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Telephone | 707-274-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 4466 CEDAR AVENUE
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City | CLEARLAKE
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State | CA
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Zip | 95422
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10456-R
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License Number State | CA
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