Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Roman

Individual provider Mental Health Counselor · NPI 1093354672

Amanda Roman is a Marriage and Family Therapist in Upland, California. Qualified in 2019, 7 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

134 Mercer Way
Upland, CA 91786-6442
Phone: (909) 997-8632
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 11057 Basye St, El Monte, CA 91731-1655 — (626) 444-0539
  • 2008 N Garey Ave, Pomona, CA 91767-2722 — (909) 623-6131

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 137707 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 115565 (CA)

Record details

NPI number1093354672
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 31, 2019
Last updated in NPPESDecember 19, 2024
Certification dateDecember 19, 2024
Mailing address134 Mercer Way, Upland, CA 91786-6442

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Upland