Myron Walters, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC48872 Issued in CA

Practice address

1368 Lincoln Ave Ste 212
San Rafael, CA 94901-2121

Phone

(415) 686-3445

NPI assigned

Aug 25, 2010

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 3, 2024 through Jan 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1619283801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 LINCOLN AVE STE 212",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012121",
            "telephone_number": "415-686-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 LINCOLN AVE STE 212",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012121",
            "telephone_number": "415-686-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MYRON",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC48872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward K Wall, DDS
• Sonya Gohel Wallace, FNP-C
• Nina Regina Noell Walterman, AMFT
• Kayla Walters, LPN
• Marjorie Gans Walters, PHD
• Samuel J. Walters, MD
• Zoe Walton, L.AC
• Lai Ping Atalanta Wan, RN, CNS
• Marissa Wang, DMD
• Samuel Wang, L.AC.

• Marriage & Family Therapist in San Rafael, CA
• Providers in San Rafael, 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 Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.