Widener, Amanda Mae
Widener, Amanda Mae is an individual health care provider with primary practice located at 1816 8Th Ave , Olivehurst CA 95961-4305. She recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Emergency Medical Service Providers / Emergency Medical Technician, Basic, Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Driver, Student, Health Care / Student in an Organized Health Care Education/Training Program, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Widener, Amanda Mae can be contacted via phone (405) 489-2179.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | California | |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | California | |
| Emergency Medical Service Providers / Emergency Medical Technician, Basic | 146N00000X | California | |
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | California | |
| Other Service Providers / Driver | 172A00000X | California | |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | California | |
| Other Service Providers / Community Health Worker | 172V00000X | California |
Profile Details
| NPI number | 1659838522 |
|---|---|
| LBN Legal business name | Widener, Amanda Mae |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2019 |
| Last updated | Apr 16th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659838522 | NPPES |
| California | Other | 116993628 | DUNS |
| California | MEDICAID | 1659838522 | DUNS |
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