Healthcare Provider Details

I. General information

NPI: 1598608101
Provider Name (Legal Business Name): TANICKIA SAKORIA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 CHELSEA ST
RIDGECREST CA
93555-3208
US

IV. Provider business mailing address

1141 CHELSEA ST
RIDGECREST CA
93555-3208
US

V. Phone/Fax

Practice location:
  • Phone: 760-463-2880
  • Fax:
Mailing address:
  • Phone: 760-463-2880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN752688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: