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NPI Code Detail

MEDICARE: AMANDA LEE JONES ACSW

MEDICARE: AMANDA LEE JONES ACSW
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
11041C0700XClinical Social WorkerASW136554CA
2101YA0400XAddiction (Substance Use Disorder) CounselorA054310225CA
3390200000XStudent in an Organized Health Care Education/Training Program
4171M00000XCase Manager/Care CoordinatorCA
5225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1396444543
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LEE JONES ACSW
Provider Business Mailing Address
First Line : 480 TESCONI CIR STE B
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4691
Country : US
Telephone Number : 707-206-7268
Fax Number :
Provider Business Practice Location Address
First Line : 480 TESCONI CIR STE B
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4691
Country : US
Telephone Number : 707-206-7268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2023
Last Update Date : 03/17/2026

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