Newport Beach Trauma Therapy, Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

NEWPORT BEACH TRAUMA THERAPY, INC

Practice address

260 Newport Center Dr Ste 206
Newport Beach, CA 92660-7520

Phone

(949) 545-8684

NPI assigned

Apr 26, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shavvonne WallsNPI 1396085007

Title

Ceo

Phone

(714) 457-7157

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shavvonne Walls

  • Marriage & Family Therapist
  • Newport Beach, CA
  • NPI 1396085007

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1902488208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NEWPORT CENTER DR STE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607520",
            "telephone_number": "949-545-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 NEWPORT CENTER DR STE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607520",
            "telephone_number": "949-545-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT BEACH TRAUMA THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "SHAVVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-457-7157"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Newport Beach Surgical and Medical Group Inc
• Newport Beach Womens Wellness Center
• Newport Brachytherapy Institute, Inc.
• Newport Cardiac & Thoracic Surgery, Inc.
• Newport Cardiovascular Associates
• Newport Care Medical Group Inc

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, 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 Aug 12, 2021; 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.