Individual provider Active NPI

Emily Anne Walsh

  • Marriage & Family Therapist
  • Carlsbad, CA
National Provider Identifier
1134769490
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141158 Issued in CA
Practice address
785 Grand Ave Ste 101
Carlsbad, CA 92008-2370
Phone
(888) 790-9377
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 110216 CA
Marriage & Family Therapist 106H00000X 141158 CA Primary

Addresses

Primary practice location

785 Grand Ave Ste 101
Carlsbad, CA 92008-2370

Mailing address

PO Box 22854
San Diego, CA 92192-2854

Other practice location 1

9445 Farnham St
San Diego, CA 92123-1399
Phone (858) 380-4676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002744 CA Practitioner - Marriage and Family Therapist 3476080912 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110216CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Beach Community Clinic CurrentSince Oct 18, 2024 Accepting new patients
Imperial Beach Community Clinic CurrentSince Oct 18, 2024 Accepting new patients

Locations

949 Palm Ave
Imperial Beach, CA 91932
Phone (619) 429-3733

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBEEDD
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10012052

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1134769490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22854",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921922854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 GRAND AVE STE 101",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082370",
            "telephone_number": "888-790-9377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9445 Farnham St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231399",
            "country_code": "US",
            "telephone_number": "858-380-4676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110216",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.