MEDICARE: DANIEL ALLAN WALKER SUDRC II

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	25461	CA

General Provider Information

NPI Number	:	1063104651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ALLAN WALKER SUDRC II

Provider Business Mailing Address
First Line	:	215 W BEAMER ST
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695-2510
Country	:	US
Telephone Number	:	530-405-2815
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 W BEAMER ST
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695-2510
Country	:	US
Telephone Number	:	530-405-2815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	04/14/2026

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