DR. NIKI DESANTO AMSDEN PH.D.
NPI 1497159461
Clinical Neuropsychologist in Roseburg, OR

Q: What is Niki Amsden's NPI number?

The NPI number for Niki Amsden is 1497159461. It was assigned to this individual provider in the NPPES registry on October 20, 2014. The provider is also known as Dr. Niki Andrea Desanto Ph.D..

Q: What is Niki Amsden's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Niki Amsden was last updated on February 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2014PECOS Enrolled

2700 STEWART PARKWAY, ANNEX B, ROSEBURG, OR 97471(541) 440-3532(541) 440-3554 Get Directions Write a Review

NPPES record last updated: February 19, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Niki Desanto Amsden Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NIKI DESANTO AMSDEN PH.D. (NPI 1497159461) is an individual clinical neuropsychologist in Roseburg, Oregon, licensed in Oregon (2464) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497159461

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameDR. NIKI DESANTO AMSDENCredential: PH.D.

Location Address2700 STEWART PARKWAY, ANNEX BRoseburg, OR 97471

Mailing Address272 Medical Loop, Suite ERoseburg, OR 97471 · (541) 440-3532 · Fax (541) 440-3554

Phone(541) 440-3532

Fax(541) 440-3554

Sole ProprietorNo

Enumeration DateOctober 20, 2014

Last NPPES UpdateFebruary 19, 2015

✔ NPI 1497159461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in OR · 2464

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY 12507 (CA)

Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X · License 2464 (OR)

2700 STEWART PARKWAY, Roseburg, OR 97471

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Other Names 1

Former Name (1)Dr. Niki Andrea Desanto Ph.d.

Other Identifiers 1

Medicaid500679588OR

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Niki Desanto Amsden Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAWNIE GOETZ-KENNEDY

Community Health Worker