Amanda Banda Raya, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
5717 E Beverly Blvd, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(323) 430-4200.
Amanda Banda Raya is licensed to practice in California (license number LCSW82340) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962671958.
Healthcare Provider's Profile
Full Name | Amanda Banda Raya |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 5717 E Beverly Blvd, Los Angeles, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1962671958
- Provider Enumeration Date: 02/25/2008
- Last Update Date: 05/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 3577938869
- Enrollment ID: I20230419002380
Medical Identifiers
Medical identifiers for Amanda Banda Raya such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962671958 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 66615 (California) | Secondary |
1041C0700X | Social Worker - Clinical | LCSW82340 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Banda Raya is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Banda Raya, LCSW Po Box 54302, Los Angeles, CA 90054-0302 Ph: () - | Amanda Banda Raya, LCSW 5717 E Beverly Blvd, Los Angeles, CA 90022-2823 Ph: (323) 430-4200 |
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