Healthcare Provider Details

I. General information

NPI: 1043005374
Provider Name (Legal Business Name): TOMISHA WALKER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RAMONA EXPY
PERRIS CA
92571-7014
US

IV. Provider business mailing address

85 RAMONA EXPY
PERRIS CA
92571-7014
US

V. Phone/Fax

Practice location:
  • Phone: 951-349-4195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number743011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: