Mallory Walters

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT125970 Issued in CA

Practice address

1100 Lincoln Ave
Ste. 206
Napa, CA 94558-4900

Phone

(415) 861-0828

Fax

(415) 861-0257

NPI assigned

May 30, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Radiant Beginnings Marriage Child & Family Therapy

  • Marriage & Family Therapist
  • Fairfield, CA
  • NPI 1366114464
  NPD (past) Authorized official

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1619314697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 FELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025144",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LINCOLN AVE",
            "address_2": "STE. 206",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945584900",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 Vicksburg Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335166",
            "country_code": "US",
            "telephone_number": "707-654-4659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT125970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1 Quality Dr",
            "city": "Vacaville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956889494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walmart Inc.
• Cari Walsh
• James Anthony Walsh, NP
• Kaycee Montana Walston, ATC
• Cynthia L. Walters, M.A.
• Laura Raquel Walton, ASW
• Pamela Jane Walton, MFT
• Fei Wang
• Ashley Marie Wanner, PSYD
• Katherine Warburton, D.O.

• Marriage & Family Therapist in Napa, CA
• Providers in Napa, 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 Dec 29, 2021; 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.