Healthcare Provider Details

I. General information

NPI: 1760991277
Provider Name (Legal Business Name): WALKER & WALKER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 W CLARK AVE
SANTA MARIA CA
93455-4624
US

IV. Provider business mailing address

1145 E CLARK AVE STE I
SANTA MARIA CA
93455-5171
US

V. Phone/Fax

Practice location:
  • Phone: 805-364-4412
  • Fax: 844-351-5566
Mailing address:
  • Phone: 805-364-4412
  • Fax: 844-351-5566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95103901
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA62652
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA62652
License Number StateCA

VIII. Authorized Official

Name: MRS. ELIZABETH WALKER
Title or Position: MANAGING OFFICER
Credential: RN
Phone: 805-364-4412