Provider Demographics
NPI:1932788866
Name:HELD, AMANDA SUSAN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SUSAN
Last Name:HELD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 HOTEL CIRCLE CT STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3423
Mailing Address - Country:US
Mailing Address - Phone:833-426-0754
Mailing Address - Fax:
Practice Address - Street 1:4420 HOTEL CIRCLE CT STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3423
Practice Address - Country:US
Practice Address - Phone:833-426-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1112011041C0700X
104100000X
WASC60852779104100000X
CA97558104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical