ANITA WALLACE
NPI 1972732204
Marriage & Family Therapist in Pasadena, CA

Q: What is Anita Wallace's NPI number?

The NPI number for Anita Wallace is 1972732204. It was assigned to this individual provider in the NPPES registry on July 8, 2009.

Q: What is Anita Wallace's specialty?

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

Q: Is Anita Wallace enrolled in Medicare?

No. Anita Wallace has opted out of Medicare through January 10, 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 Anita Wallace was last updated on July 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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 July 08, 2009Opted out of Medicare · through Jan 10, 2028

2500 E FOOTHILL BLVD, PASADENA, CA 91107(626) 564-1613 Get Directions Write a Review

NPPES record last updated: July 8, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Anita Wallace NPPES

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

ANITA WALLACE (NPI 1972732204) is an individual marriage & family therapist in Pasadena, California, licensed in California (MFC 44773) and active in the NPI registry since July 2009. She has opted out of Medicare through January 10, 2028.

NPPES Registry Identity

NPI1972732204

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameANITA WALLACE

Location Address2500 E FOOTHILL BLVDPasadena, CA 91107-3464

Mailing Address2500 E Foothill BlvdPasadena, CA 91107-3464 · (626) 564-1613

Phone(626) 564-1613

Sole ProprietorNo

Enumeration DateJuly 8, 2009

✔ NPI 1972732204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · MFC 44773

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.

2500 E FOOTHILL BLVD, Pasadena, CA 91107

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Anita Wallace 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 10, 2024 through January 10, 2028.

Opt-Out Effective DateJanuary 10, 2024

Opt-Out In Effect ThroughJanuary 10, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA HARATOUNIAN

Psychologist