Healthcare Provider Details

I. General information

NPI: 1679991319
Provider Name (Legal Business Name): JUDIANNE WALKER D.P.M. CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 EL CAPITAN DR #410
DANVILLE CA
94526-6258
US

IV. Provider business mailing address

1320 EL CAPITAN DR #410
DANVILLE CA
94526-6258
US

V. Phone/Fax

Practice location:
  • Phone: 925-830-2929
  • Fax: 925-830-4770
Mailing address:
  • Phone: 925-830-2929
  • Fax: 925-830-4770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5001
License Number StateCA

VIII. Authorized Official

Name: DR. JUDIANNE M. WALKER
Title or Position: PRESIDENT/PODIATRIST
Credential: D.P.M.
Phone: 925-830-2929