Individual provider Active NPI

David John Wolter, M.A. MFT

  • Marriage & Family Therapist
  • Clovis, CA
National Provider Identifier
1679736250
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC49749 Issued in CA
Practice address
264 Clovis Ave
Clovis, CA 93612-1115
Phone
(559) 545-7087
Fax
(559) 324-6565
NPI assigned
Jul 3, 2008
Last updated
Mar 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC49749 CA Primary

Addresses

Primary practice location

264 Clovis Ave
Clovis, CA 93612-1115

Mailing address

264 Clovis Ave
Clovis, CA 93612-1115
Phone (559) 545-7087

Other identifiers 1

IdentifierTypeStateIssuer
MFC49749OtherCABBS

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC49749CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clovis Family Therapy, Inc. Marriage & Family Therapist Current Accepting new patients

Locations

264 Clovis Ave
Clovis, CA 93612
Phone (559) 545-7087

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1679736250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 CLOVIS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121115",
            "telephone_number": "559-545-7087",
            "fax_number": "559-324-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 CLOVIS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936121115",
            "telephone_number": "559-545-7087",
            "fax_number": "559-324-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTER",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "M.A. MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC49749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "MFC49749",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.