Provider Demographics
NPI:1386315927
Name:WALTERS WELLNESS & PSYCHOLOGY GROUP, APC
Entity type:Organization
Organization Name:WALTERS WELLNESS & PSYCHOLOGY GROUP, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DR. CATHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-499-4054
Mailing Address - Street 1:2161 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1701
Mailing Address - Country:US
Mailing Address - Phone:510-499-4054
Mailing Address - Fax:
Practice Address - Street 1:2161 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1701
Practice Address - Country:US
Practice Address - Phone:510-499-4054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty