Nathanael Waller, MFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

113076 Issued in CA

Practice address

2500 N Palm Canyon Dr Ste A4
Palm Springs, CA 92262-1866

Phone

(442) 268-7000

NPI assigned

Sep 5, 2019

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not 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.

• Recovery Innovations, Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1902776107
  NPD (past)

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1659920452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E PALM CANYON DR STE 110",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641623",
            "telephone_number": "442-268-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N PALM CANYON DR STE A4",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621866",
            "telephone_number": "442-268-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "NATHANAEL",
        "credential": "MFTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Oliver L Walker Jr.
• William Aron Walker, MD
• Walmart Inc.
• Walmart Stores, Inc.
• Bryn Walsh
• Lauren C Walsh
• Walter J Erhman, MD Inc

• Marriage & Family Therapist in Palm Springs, CA
• Providers in Palm Springs, 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 Sep 5, 2019; 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.