MEDICARE: AMANDA BARNETT 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	LCS18037	CA

General Provider Information

NPI Number	:	1427156561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA BARNETT LCSW

Provider Business Mailing Address
First Line	:	20720 VENTURA BLVD
Second Line	:	SUITE 210
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2306
Country	:	US
Telephone Number	:	818-754-4644
Fax Number	:	818-587-3353

Provider Business Practice Location Address
First Line	:	20720 VENTURA BLVD
Second Line	:	SUITE 210
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2306
Country	:	US
Telephone Number	:	818-754-4644
Fax Number	:	818-587-3353

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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