Healthcare Provider Details

I. General information

NPI: 1962261149
Provider Name (Legal Business Name): CYDNEY JEAN WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9490 GENESEE AVE
LA JOLLA CA
92037-1302
US

IV. Provider business mailing address

9058 INVERNESS RD
SANTEE CA
92071-2217
US

V. Phone/Fax

Practice location:
  • Phone: 858-453-3440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: