Individual provider Active NPI

Alyssa Wells, LMFT

  • Marriage & Family Therapist
  • Ceres, CA
National Provider Identifier
1013441989
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
116557 Issued in CA
Practice address
1904 Richland Ave
Ceres, CA 95307-4562
Phone
(209) 558-4600
NPI assigned
Apr 17, 2017
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Marriage & Family Therapist 106H00000X 116557 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1904 Richland Ave
Ceres, CA 95307-4562

Mailing address

PO Box 1246
Turlock, CA 95381-1246
Phone (209) 402-0390

Other identifiers 1

IdentifierTypeStateIssuer
1013441989MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
116557CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1013441989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1246",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953811246",
            "telephone_number": "209-402-0390",
            "fax_number": "209-402-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 RICHLAND AVE",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953074562",
            "telephone_number": "209-558-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "ALYSSA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "116557",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013441989",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceres, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.