MEDICARE: AMANDA DUWICK PMHNP-BC, MSN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95006841	CA

General Provider Information

NPI Number	:	1710344999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA DUWICK PMHNP-BC, MSN

Provider Business Mailing Address
First Line	:	23333 IDA PL
Second Line	:
City	:	CHATSWORTH
State	:	CA
Zip	:	91311-6416
Country	:	US
Telephone Number	:	818-314-6650
Fax Number	:

Provider Business Practice Location Address
First Line	:	31111 AGOURA RD STE 100
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4450
Country	:	US
Telephone Number	:	805-750-5074
Fax Number	:

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

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	01/17/2025

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