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General NPI Number Information
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NPI Number | 1477256840
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Entity Type | Individual
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Provider Name | AMANDA G SILLARS MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 975 CALLE CASTANO
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4641
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Country | US
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Telephone | 818-613-5446
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Fax | 805-228-0008
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Provider Business Mailing Address
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Address Line | 365 E AVENIDA DE LOS ARBOLES STE 1025
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-2975
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Country | US
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Telephone | 805-917-2005
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Fax | 805-228-0008
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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 | LCS18557
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License Number State | CA
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