Active NPI
Linda Ann Wall, PH.D.
- Psychologist
- La Canada, CA
National Provider Identifier
1013014018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY12777
- Practice address
- 4440 Chevy Chase Dr
La Canada, CA 91011-3214 - Phone
- (626) 449-5585
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY12777 | CA | Primary |
Addresses
Primary practice location
4440 Chevy Chase Dr
La Canada, CA 91011-3214
Mailing address
PO Box 561
La Canada, CA 91012-0561
Phone (626) 449-5585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12777 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013014018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 561",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910120561",
"telephone_number": "626-449-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 CHEVY CHASE DR",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910113214",
"telephone_number": "626-449-5585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "LINDA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY12777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Canada, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.