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General NPI Number Information
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NPI Number | 1396444543
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Entity Type | Individual
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Provider Name | AMANDA LEE JONES
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 2245 CHALLENGER WAY
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City | SANTA ROSA
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State | CA
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Zip | 95407-5418
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Country | US
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Telephone | 707-565-4857
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Fax |
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Provider Business Mailing Address
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Address Line | 480 TESCONI CIR STE B
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City | SANTA ROSA
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State | CA
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Zip | 95401-4691
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Country | US
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Telephone | 707-206-7268
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW136554
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A054310225
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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