Healthcare Provider Details

I. General information

NPI: 1902001126
Provider Name (Legal Business Name): ELVIRA C. WALKER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 10/18/2023
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 E NAPLES PLZ STE 301
LONG BEACH CA
90803-5091
US

IV. Provider business mailing address

6475 E PACIFIC COAST HWY # 385
LONG BEACH CA
90803-4201
US

V. Phone/Fax

Practice location:
  • Phone: 562-861-9191
  • Fax: 562-597-3563
Mailing address:
  • Phone: 562-225-8315
  • Fax: 562-597-3563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY21430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: