Healthcare Provider Details

I. General information

NPI: 1366653644
Provider Name (Legal Business Name): AMY WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 JACKSON ST
HAYWARD CA
94544-1530
US

IV. Provider business mailing address

409 JACKSON ST
HAYWARD CA
94544-1530
US

V. Phone/Fax

Practice location:
  • Phone: 510-891-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number87588
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: