Active NPI
Julie Wallin
- Peer Specialist
- Citrus Heights, CA
National Provider Identifier
1639925647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-EFHWTK
- Practice address
- 8421 Auburn Blvd Ste 162
Citrus Heights, CA 95610-0359 - Phone
- (916) 441-3819
- Fax
- (916) 441-6377
- NPI assigned
- Apr 29, 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Peer Specialist | 175T00000X | MPSS-EFHWTK | CA | Primary |
Addresses
Primary practice location
8421 Auburn Blvd Ste 162
Citrus Heights, CA 95610-0359
Mailing address
3780 Rosin CT Ste 110
Sacramento, CA 95834-1698
Phone (916) 441-0226
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 |
|---|---|---|---|
| MPSS-EFHWTK | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1639925647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3780 ROSIN CT STE 110",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341698",
"telephone_number": "916-441-0226",
"fax_number": "916-441-0286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8421 AUBURN BLVD STE 162",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956100359",
"telephone_number": "916-441-3819",
"fax_number": "916-441-6377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIN",
"first_name": "JULIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-29",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-EFHWTK",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.