Individual provider Active NPI

Walter Daniel Tolbert Jr., BA

  • Mental Health Counselor
  • Oceanside, CA
National Provider Identifier
1770066003
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1738 S Tremont St
Oceanside, CA 92054-5309
Phone
(760) 439-2800
Fax
(760) 740-0641
NPI assigned
Sep 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1738 S Tremont St
Oceanside, CA 92054-5309

Mailing address

1738 S Tremont St
Oceanside, CA 92054-5309
Phone (760) 439-2800

Other practice location 1

474 W Vermont Ave Ste 103
Escondido, CA 92025-6584
Phone (760) 294-1281

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
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1770066003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 S TREMONT ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545309",
            "telephone_number": "760-439-2800",
            "fax_number": "760-740-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 S TREMONT ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545309",
            "telephone_number": "760-439-2800",
            "fax_number": "760-740-0641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "474 W Vermont Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920256584",
            "country_code": "US",
            "telephone_number": "760-294-1281",
            "fax_number": "760-740-0641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "WALTER",
        "middle_name": "DANIEL",
        "name_suffix": "Jr.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.