Provider Demographics
NPI:1316830029
Name:WALSH, KIRRA (AMFT)
Entity type:Individual
Prefix:MRS
First Name:KIRRA
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 W VALLEY PKWY # 252
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-2554
Mailing Address - Country:US
Mailing Address - Phone:619-203-9316
Mailing Address - Fax:
Practice Address - Street 1:1 CIVIC CENTER DR STE 320
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3193
Practice Address - Country:US
Practice Address - Phone:760-566-5516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist