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General NPI Number Information
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NPI Number | 1194688739
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Entity Type | Individual
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Provider Name | TIMOTHY WILLIAM WALROD
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Gender | Male
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 82 CLARKSVILLE RD
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City | FOLSOM
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State | CA
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Zip | 95630-8209
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Country | US
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Telephone | 916-983-8868
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Fax |
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Provider Business Mailing Address
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Address Line | 3675 T ST APT 136
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City | SACRAMENTO
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State | CA
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Zip | 95816-6665
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Country | US
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Telephone | 916-983-8868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95037789
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License Number State | CA
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