Individual
DR. AMY DIAN WALTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1229 MARIN AVE, ALBANY, CA 94706-2034
(510) 595-4628
Mailing address
1229 MARIN AVE, ALBANY, CA 94706-2034
(510) 595-4628
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY20841
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC80240F
MEDICAL PROVIDER #
CA
Enumeration date
05/31/2007
Last updated
08/05/2014
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