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NPI Code Detail

MEDICARE: MR. WILLIAM STALLWORTH MS, PPS, AMFT

MEDICARE: MR. WILLIAM STALLWORTH MS, PPS, AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist128044CA
2101YS0200XSchool Counselor210136286CA

General Provider Information

NPI Number : 1033076203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM STALLWORTH MS, PPS, AMFT
Provider Business Mailing Address
First Line : 36300 FREMONT BLVD
Second Line :
City : FREMONT
State : CA
Zip : 94536-3511
Country : US
Telephone Number : 510-796-1776
Fax Number :
Provider Business Practice Location Address
First Line : 36300 FREMONT BLVD
Second Line :
City : FREMONT
State : CA
Zip : 94536-3511
Country : US
Telephone Number : 510-796-1776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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