Provider Demographics
NPI:1619178191
Name:WALINSKI, MEGAN (MA, MFT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WALINSKI
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 TROTTER WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1276 LINCOLN AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-3050
Practice Address - Country:US
Practice Address - Phone:510-673-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
IMF 46447106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist