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NPI Code Detail

MEDICARE: AMANDA SOMMER BOONE

MEDICARE: AMANDA SOMMER BOONE
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1699245449CA

General Provider Information

NPI Number : 1699245449
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SOMMER BOONE
Provider Business Mailing Address
First Line : 2550 W CLINTON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-4201
Country : US
Telephone Number : 559-264-7521
Fax Number :
Provider Business Practice Location Address
First Line : 3707 E SHIELDS AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-7029
Country : US
Telephone Number : 559-229-9040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 06/08/2026

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Directions to “ AMANDA SOMMER BOONE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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