Active NPI
Paige Walters
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1598476756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 151863
- Practice address
- 110 Stony Point Rd
Santa Rosa, CA 95401-4189 - Phone
- (707) 890-3800
- NPI assigned
- Dec 8, 2022
- Last updated
- Dec 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 151863 | CA | MD | Marriage & Family Therapist |
| 10234 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Rosa City Schools | Current | 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.
-
- Local Education Agency (LEA)
- Santa Rosa, CA
- NPI 1689790644
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.