MEDICARE: AMANDA LIVINGSTON-MEJIA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	136860	CA
2	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013419852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LIVINGSTON-MEJIA LCSW

Provider Business Mailing Address
First Line	:	PO BOX 942056
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93094-2056
Country	:	US
Telephone Number	:	805-410-3858
Fax Number	:

Provider Business Practice Location Address
First Line	:	14899 MARQUETTE ST
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-2560
Country	:	US
Telephone Number	:	805-410-3858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2018
Last Update Date	:	06/01/2026

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