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NPI Code Detail

MEDICARE: JENNA NICOLE WALKER

MEDICARE:   JENNA NICOLE WALKER
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073445649
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA NICOLE WALKER
Provider Business Mailing Address
First Line : 13409 MIDLAND RD APT 189
Second Line :
City : POWAY
State : CA
Zip : 92064-4778
Country : US
Telephone Number : 858-208-8230
Fax Number :
Provider Business Practice Location Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number : 619-579-8685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “ JENNA NICOLE WALKER ” Practice Location

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