Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MICHELLE MARIE WAMBACH LMFT, PSY.D
NPI 1619507472
Marriage & Family Therapist in San Jose, CA

Q: What is Michelle Wambach's NPI number?

The NPI number for Michelle Wambach is 1619507472. It was assigned to this individual provider in the NPPES registry on January 21, 2020.

Q: What is Michelle Wambach's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Michelle Wambach enrolled in Medicare?

No. Michelle Wambach has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Michelle Wambach was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 21, 2020Opted out of Medicare · through Jan 1, 2028

4020 MOORPARK AVE STE 206, SAN JOSE, CA 95117(408) 279-7909 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 13, 2026, Jan 21, 2020 (2 updates tracked since 2020).

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About Dr. Michelle Marie Wambach Lmft, Psy.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHELLE MARIE WAMBACH LMFT, PSY.D (NPI 1619507472) is an individual marriage & family therapist in San Jose, California, licensed in California (MFC41571) and active in the NPI registry since January 2020. She has opted out of Medicare through January 1, 2028 and maintains a secondary practice location in Campbell.

NPPES Registry Identity

NPI1619507472

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameDR. MICHELLE MARIE WAMBACHCredential: LMFT, PSY.D

Location Address4020 MOORPARK AVE STE 206San Jose, CA 95117-1846

Mailing Address4020 Moorpark Ave Ste 206San Jose, CA 95117-1846 · (408) 247-7909

Phone(408) 279-7909

Sole ProprietorYes

Enumeration DateJanuary 21, 2020

Last NPPES UpdateAugust 13, 20262 updates tracked since enumeration

NPPES CertifiedAugust 13, 2026

✔ NPI 1619507472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Licenses✔ Licensed in CA · MFC41571✔ Licensed in CA · 41571

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

4020 MOORPARK AVE STE 206, San Jose, CA 95117

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Secondary Practice Location 1

Location 1307 Orchard City Dr Ste 310Campbell, CA 95008-2948 · Phone (408) 247-7909

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michelle Marie Wambach Lmft, Psy.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Wambach's NPI number?

The NPI number for Michelle Wambach is 1619507472. It was assigned to this individual provider in the NPPES registry on January 21, 2020.

Where is Michelle Wambach located?

Michelle Wambach practices at 4020 Moorpark Ave Ste 206, San Jose, CA 95117. The listed phone number is (408) 279-7909.

What is Michelle Wambach's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Michelle Wambach enrolled in Medicare?

No. Michelle Wambach has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michelle Wambach was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.