Michelle Marie Wambach, LMFT, PSY.D

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC41571 Issued in CA

Practice address

4020 Moorpark Ave Ste 206
San Jose, CA 95117-1846

Phone

(408) 279-7909

NPI assigned

Jan 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1619507472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 MOORPARK AVE STE 206",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171846",
            "telephone_number": "408-247-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 MOORPARK AVE STE 206",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171846",
            "telephone_number": "408-279-7909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Orchard City Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "950082948",
            "country_code": "US",
            "telephone_number": "408-247-7909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAMBACH",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "LMFT, PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "41571",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC41571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Walton
• Michelle Nicole Walton
• Heather Waltz
• John Randall Waltz, MPT
• Emma-Louise Wamain
• Hsienshu Wan
• Timothy Andrew Wan
• Amanda Wang
• Angela Wang
• Austin Wang, PHARMD

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, 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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.