Jennifer L Walters

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

52661 Issued in CA

Practice address

9500 Haven Ave
Suite 200
Rancho Cucamonga, CA 91730-5807

Phone

(909) 240-2611

NPI assigned

Feb 19, 2008

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1548438971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7369",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923750369",
            "telephone_number": "909-792-0747",
            "fax_number": "909-792-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 HAVEN AVE",
            "address_2": "SUITE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305807",
            "telephone_number": "909-240-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54254",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlena Walls
• Walmart Inc.
• Ian Robert Walnofer
• Sharon Walsh, LMFT
• Sophie G Walter
• Priscilla Philips Walters, PT
• Rachael Walters
• Kimberly Wampler
• Alice Wentsuo Wang, M.D.
• Ivy Wang

• Marriage & Family Therapist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Jul 25, 2013; 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.