Individual
AMANDA M WILBUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6840 INDIANA AVE STE 275, RIVERSIDE, CA 92506-4279
(951) 788-0230
Mailing address
2751 RECHE CANYON RD UNIT SP85, COLTON, CA 92324-9570
(951) 285-9890
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW99373
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
PRIVATE
CA
Enumeration date
05/27/2021
Last updated
05/27/2021
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