Provider Demographics
NPI:1225783079
Name:HOWARD-WALLER, ASHA Y (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:Y
Last Name:HOWARD-WALLER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 ADOBE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4654
Mailing Address - Country:US
Mailing Address - Phone:510-938-2726
Mailing Address - Fax:
Practice Address - Street 1:68 ADOBE DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4654
Practice Address - Country:US
Practice Address - Phone:510-938-2726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36946106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist