Organization Active NPI

Innovative Therapy 4 Kids Inc

  • Clinical Psychologist
  • Carlsbad, CA
National Provider Identifier
1760579015
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
SP9589 Issued in CA
Legal business name
INNOVATIVE THERAPY 4 KIDS INC
Practice address
2333 State St
Suite 201
Carlsbad, CA 92008-1691
Phone
(760) 434-3912
Fax
(760) 434-3871
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Laura Jane Walls, MS CCCSLP
Title
Oral Motor Specialist Director
Phone
(760) 434-3912

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X SP9589 CA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X SP9589 CA Primary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X SP9589 CA
Neurorehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XN1300X SP9589 CA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP9589 CA

Addresses

Primary practice location

2333 State St
Suite 201
Carlsbad, CA 92008-1691

Mailing address

2333 State St
Suite 201
Carlsbad, CA 92008-1691
Phone (760) 434-3912

National Provider Directory

National Provider Directory

Locations

2333 State St
Ste 201
Carlsbad, CA 92008
Phone (760) 434-3912

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1760579015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 STATE ST",
            "address_2": "SUITE 201",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081691",
            "telephone_number": "760-434-3912",
            "fax_number": "760-434-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 STATE ST",
            "address_2": "SUITE 201",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081691",
            "telephone_number": "760-434-3912",
            "fax_number": "760-434-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY 4 KIDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "ORAL MOTOR SPECIALIST DIRECTOR",
        "authorized_official_telephone_number": "760-434-3912",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS CCCSLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "SP9589",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "SP9589",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "SP9589",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CA",
            "license": "SP9589",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP9589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.