Healthcare Provider Details

I. General information

NPI: 1245124221
Provider Name (Legal Business Name): TASHA L WALKER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35285 HOPEWELL RD
SQUAW VALLEY CA
93675-9673
US

IV. Provider business mailing address

35285 HOPEWELL RD
SQUAW VALLEY CA
93675-9673
US

V. Phone/Fax

Practice location:
  • Phone: 559-907-5825
  • Fax:
Mailing address:
  • Phone: 559-907-5825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: