Active NPI
Ellen Walters
- Marriage & Family Therapist
- Walnut Creek, CA
National Provider Identifier
1053393371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 36369
- Practice address
- 1756 Lacassie Ave
Suite 103
Walnut Creek, CA 94596-7098 - Phone
- (925) 934-4647
- NPI assigned
- Nov 14, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 36369 | CA | Primary |
Addresses
Primary practice location
1756 Lacassie Ave
Suite 103
Walnut Creek, CA 94596-7098
Mailing address
1756 Lacassie Ave
Suite 103
Walnut Creek, CA 94596-7098
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36369 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053393371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1756 LACASSIE AVE",
"address_2": "SUITE 103",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945967098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1756 LACASSIE AVE",
"address_2": "SUITE 103",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945967098",
"telephone_number": "925-934-4647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "36369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.