Look up the most recent NPI and PECOS records

Amanda Williams

Behavior Technician

Behavioral Health & Social Service Providers

12125 Day St Ste Ee301, Moreno Valley, CA 92557-6702

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Williams does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1356832406
Provider Type
Individual
Full Name
Williams, Amanda
Gender
Female

Sole Proprietor
No
Enumeration Date
5/24/2018
Last Updated
5/24/2018

Contact Information

Practice Location

12125 Day St Ste Ee301, Moreno Valley, CA 92557-6702

(951) 344-2166

Unlisted Fax

Mailing Location

21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807

(818) 345-2345

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer California

Provider Identifiers

ID	Description	Issuer
ID R12167875	Description Medicaid	Issuer Unlisted California

Amanda Williams

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Ayala, Kelly

Ledesma, Mireya Matilde

Valencia, Jilliann

Manzo, Kat

Schafer, Victoria

Guerrero, Anthony Isaiah

Mendoza, Jazmine Andrea

Vasquez, Lairen Michele

Escamilla, Stacey

Karoki, Mary