Individual provider · NPI-1

Samantha Marie Amezcua

Peer Specialist · Long Beach, CA

NPI number1861367542
StatusActive
Last updated in NPPESOct 24, 2025

Details

NPI
1861367542
Entity type
Individual (NPI-1)
Name
Samantha Marie Amezcua
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 10, 2025
Certification date
Oct 24, 2025
Last updated
Oct 24, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer SpecialistMPSS-QTHDYJCAYes

Practice location

2101 Magnolia Ave
Long Beach, CA 90806-4521

Phone 562-218-1868

Mailing address

863 N Vail Ave
Montebello, CA 90640-2432

Phone 323-770-5452

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