Shavvonne Walls

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

84959 Issued in CA

Practice address

260 Newport Center Dr Ste 210
Newport Beach, CA 92660-7520

Phone

(949) 371-9921

NPI assigned

Feb 18, 2013

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Newport Beach Trauma Therapy, Inc

  • Marriage & Family Therapist
  • Newport Beach, CA
  • NPI 1902488208

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1396085007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NEWPORT CENTER DR STE 210",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607520",
            "telephone_number": "949-371-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 NEWPORT CENTER DR STE 210",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607520",
            "telephone_number": "949-371-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "SHAVVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "1833",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Owen Walker, PA
• Todd Michael Walkow, DMD
• Michelle Wall, P.T.
• Casey Stephen Wallace, DPT
• Melia Wallin, PSY.D.
• Anne Marie Walsh, P.A.
• Lauren Nicole Walstead
• Curtis Fred Walter, RCP
• Sheryl Stephanie Wamsley-Goldsmith, LCSW
• Wanda Von Kleist, PH.D. & Associates, a Psychological Corporation

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.