Healthcare Provider Details

I. General information

NPI: 1700075488
Provider Name (Legal Business Name): ALERICE E WALKER P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALERICE E WRIGHT

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 HEALTH CENTER DR
SAN DIEGO CA
92123-2762
US

IV. Provider business mailing address

333 S MAIN ST
NEWTOWN CT
06470-2743
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-6531
  • Fax:
Mailing address:
  • Phone: 203-426-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA70046112
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008642
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number53102
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: