Erica Wallace

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

125 W Thousand Oaks Blvd Ste 500
Thousand Oaks, CA 91360-4462

Phone

(805) 777-3500

NPI assigned

Aug 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• County of Ventura

  • Community/Behavioral Health Agency
  • Thousand Oaks, CA
  • NPI 1467571422
  NPD
• County of Ventura

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD (past)

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1447925268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 VASSAR AVE UNIT 16",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033533",
            "telephone_number": "636-373-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W THOUSAND OAKS BLVD STE 500",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604462",
            "telephone_number": "805-777-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Waldberg, PT, MOMT
• Glenn Eric Waldman, M.D.
• Donald Waldrep, M.D.
• Walgreen Co
• Sophia Julie Lynn Wall
• Harvey I Wallack, M.D.
• Walmart Inc.
• Walter Alain Thomas M D Inc
• Rhandi Walters, LMFT
• Jeffrey Yin Wang, MD

• Marriage & Family Therapist in Thousand Oaks, CA
• Providers in Thousand Oaks, 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 Sep 12, 2022; 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.