Destanie Vanderwalker, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

149482 Issued in CA

Practice address

9825 County Farm Rd
Riverside, CA 92503-3504

Phone

(951) 826-6318

NPI assigned

Oct 15, 2024

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": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1972323897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 FRIESIAN ST",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603950",
            "telephone_number": "951-454-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 COUNTY FARM RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033504",
            "telephone_number": "951-826-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWALKER",
        "first_name": "DESTANIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Vance
• Dustin John Vander Haar, MFT
• Alyssa Vander Hill, BCBA
• Abigail Vanderfin
• Sarah Vanderplate
• Lisa K. Vanegas, CADC-1
• Rachel Vanegas
• Vanessa Ho MD
• Shawnee Vang
• Tiang Vang

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, 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 Oct 15, 2024; 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.