Active NPI
Sally S. Wall, LCSW
- Clinical Social Worker
- Yountville, CA
National Provider Identifier
1609094523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13165
- Practice address
- 150 California Drive
Yountville, CA 94599-1418 - Phone
- (707) 944-4578
- Fax
- (707) 944-4590
- NPI assigned
- Apr 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13165 | NU | Primary |
Addresses
Primary practice location
150 California Drive
Yountville, CA 94599-1418
Mailing address
150 California Drive
Yountville, CA 94599-1418
Phone (707) 944-4578
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13165 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Veterans Home of California | Past | Accepting new patients |
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.
-
- Skilled Nursing Facility
- Yountville, CA
- NPI 1104811751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609094523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 CALIFORNIA DRIVE",
"city": "YOUNTVILLE",
"state": "CA",
"postal_code": "945991418",
"telephone_number": "707-944-4578",
"fax_number": "707-944-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CALIFORNIA DRIVE",
"city": "YOUNTVILLE",
"state": "CA",
"postal_code": "945991418",
"telephone_number": "707-944-4578",
"fax_number": "707-944-4590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "SALLY",
"middle_name": "S.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": "13165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yountville, CA
- Veterans Home of California (Veterans Home of California-Yountville)
- Veterans Home of California (Veterans Home of California-Yountville)
- Veterans Home of California (Veterans Home of California-Yountville)
- Veterans Home of California
- James David Vye Jr., DPT
- Joan Christine Wellington, R.D.
- Jason Withrow
- Amy Yang, RPH
- Susan Lyn Zimny, ACSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.