Individual provider Active NPI

Janis Nelson Walters, LMFT, LPCC

  • Professional Counselor
  • Gold River, CA
National Provider Identifier
1336613645
Registry record updated Jan 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
46779 Issued in CA
Practice address
11230 Gold Express Dr # 310-254
Gold River, CA 95670-4484
Phone
(916) 365-7874
NPI assigned
Jan 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 80 CA
Professional Counselor 101YP2500X 80
Marriage & Family Therapist 106H00000X 46779
Marriage & Family Therapist 106H00000X 46779 CA
Professional Counselor 101YP2500X 46779 CA Primary

Addresses

Primary practice location

11230 Gold Express Dr # 310-254
Gold River, CA 95670-4484

Mailing address

11230 Gold Express Dr # 310-254
Gold River, CA 95670-4484
Phone (916) 365-7874

Other practice location 1

7819 Magnolia Ave
Fair Oaks, CA 95628-7369
Phone (916) 365-7874

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

LicenseStateTypeSpecialty
80CAMDProfessional Counselor
46779CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547942400000",
    "number": "1336613645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 GOLD EXPRESS DR # 310-254",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704484",
            "telephone_number": "916-365-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 GOLD EXPRESS DR # 310-254",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704484",
            "telephone_number": "916-365-7874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7819 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956287369",
            "country_code": "US",
            "telephone_number": "916-365-7874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JANIS",
        "middle_name": "NELSON",
        "credential": "LMFT, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-20",
        "last_updated": "2019-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "80",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "80",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "46779",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46779",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "46779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2019; 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.