Individual
MS. AMBER NICOLE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW(CA 129938)
Contact information
Practice address
4250 FOWLER LN STE 204, DIAMOND SPRINGS, CA 95619-9782
(530) 626-3105
Mailing address
3600 DATA DR APT 57, RANCHO CORDOVA, CA 95670-7907
(703) 853-0789
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW129938
CA
1041C0700X
Clinical Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2016
Last updated
06/01/2025
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