Healthcare Provider Details

I. General information

NPI: 1720489503
Provider Name (Legal Business Name): JULIE COLLINS WALKER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 UNIVERSITY CENTER LN STE 200
SAN DIEGO CA
92122-1008
US

IV. Provider business mailing address

PO BOX 232410
SAN DIEGO CA
92193-2410
US

V. Phone/Fax

Practice location:
  • Phone: 855-543-0333
  • Fax: 858-535-6422
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT292806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: