Provider Demographics
NPI:1871085738
Name:JILK, AMANDA CHRISTINA (LMFT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHRISTINA
Last Name:JILK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTINA
Other - Last Name:JILK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 4261
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90711-4261
Mailing Address - Country:US
Mailing Address - Phone:714-512-2368
Mailing Address - Fax:
Practice Address - Street 1:11423 187TH ST STE 101
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5656
Practice Address - Country:US
Practice Address - Phone:877-538-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT132554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty