Individual provider Active NPI

Olivia Charlotte Walker

  • Marriage & Family Therapist
  • Costa Mesa, CA
National Provider Identifier
1376362012
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT150103 Issued in CA
Practice address
940 S Coast Dr Ste 260
Costa Mesa, CA 92626-7719
Phone
(949) 524-4313
NPI assigned
Oct 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT150103 CA Primary

Addresses

Primary practice location

940 S Coast Dr Ste 260
Costa Mesa, CA 92626-7719

Mailing address

940 S Coast Dr Ste 260
Costa Mesa, CA 92626-7719

Other practice location 1

543 Bernard St Unit A
Costa Mesa, CA 92627-2610
Phone (657) 675-3773

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
AMFT150103CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1376362012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 S COAST DR STE 260",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 S COAST DR STE 260",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267719",
            "telephone_number": "949-524-4313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Bernard St Unit A",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926272610",
            "country_code": "US",
            "telephone_number": "657-675-3773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "OLIVIA",
        "middle_name": "CHARLOTTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT150103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.