Vicka Malone Stout, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

12976 Issued in CA

Practice address

2918 Indian Creek Dr
Bishop, CA 93514-2912

Phone

(760) 920-2072

NPI assigned

Sep 20, 2023

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1902684897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 INDIAN CREEK DR",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142912",
            "telephone_number": "760-920-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 INDIAN CREEK DR",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142912",
            "telephone_number": "760-920-2072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 Woodside Dr",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "CA",
            "postal_code": "961411333",
            "country_code": "US",
            "telephone_number": "760-920-2072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "823 Willow Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956302375",
            "country_code": "US",
            "telephone_number": "760-920-2072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "VICKA",
        "middle_name": "MALONE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "12976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Bishop, CA
• Providers in Bishop, 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 20, 2023; 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.