Individual
AMANDA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2617 K ST STE 125, SACRAMENTO, CA 95816-5133
(916) 425-3311
Mailing address
2617 K ST STE 125, SACRAMENTO, CA 95816-5133
(916) 425-3311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
25790
CA
1041C0700X
Clinical Social Worker
20197
CA
1041C0700X
Clinical Social Worker
LCS25790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790888998
—
CA
Enumeration date
09/06/2006
Last updated
03/20/2023
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