MEDICARE: TIMOTHY WILLIAM WALROD

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95037789	CA

General Provider Information

NPI Number	:	1194688739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY WILLIAM WALROD

Provider Business Mailing Address
First Line	:	3675 T ST APT 136
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-6665
Country	:	US
Telephone Number	:	916-983-8868
Fax Number	:

Provider Business Practice Location Address
First Line	:	82 CLARKSVILLE RD
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-8209
Country	:	US
Telephone Number	:	916-983-8868
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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