| Amanda Ware, Licensed Clinical Social Worker Inc | |
|
9333 Fairway View Place Suite 101 Rancho Cucamonga CA 91730 | |
| (909) 600-4849 | |
| (909) 296-6527 |
| Full Name | Amanda Ware, Licensed Clinical Social Worker Inc |
|---|---|
| Speciality | Social Worker |
| Location | 9333 Fairway View Place Suite 101, Rancho Cucamonga, California |
| Authorized Official Name and Position | Amanda Jo Ware (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9096004849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Ware, Licensed Clinical Social Worker Inc 7349 Milliken Ave. #140-260 Rancho Cucamonga CA 91730 Ph: (909) 600-4849 | Amanda Ware, Licensed Clinical Social Worker Inc 9333 Fairway View Place Suite 101 Rancho Cucamonga CA 91730 Ph: (909) 600-4849 |
| NPI Number | 1770140378 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 3577058577 |
|---|---|
| Medicare Enrollment ID | O20251217002509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770140378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Amanda Jo Ware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255564845 PECOS PAC ID: 5395230395 Enrollment ID: I20251217002584 |
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