Individual provider Active NPI

Paige Walters

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1598476756
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
151863 Issued in CA
Practice address
110 Stony Point Rd
Santa Rosa, CA 95401-4189
Phone
(707) 890-3800
NPI assigned
Dec 8, 2022
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10234 CA
Marriage & Family Therapist 106H00000X 151863 CA Primary

Addresses

Primary practice location

110 Stony Point Rd
Santa Rosa, CA 95401-4189

Mailing address

PO Box 8512
Santa Rosa, CA 95407-1512
Phone (707) 341-6626

Other names 1

  • Paige Gasper Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.srcschools.org Direct

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
151863CAMDMarriage & Family Therapist
10234CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa City Schools CurrentSince Jan 12, 2025 Accepting new patients

Locations

110 Stony Point Rd
Santa Rosa, CA 95401
Phone (707) 535-5600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1598476756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8512",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954071512",
            "telephone_number": "707-341-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014189",
            "telephone_number": "707-890-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "10234",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "151863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.srcschools.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "110 Stony Point Rd",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954014189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "GASPER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

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