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General NPI Number Information
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NPI Number | 1588090542
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Entity Type | Individual
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Provider Name | SEAN PAUL WALKER B.A.
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Gender | Male
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 1501 HUGHES WAY SUIT 150
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City | LONG BEACH
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State | CA
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Zip | 90810-1876
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Country | US
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Telephone | 310-221-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 947 COLE AVE FL 2
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City | LOS ANGELES
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State | CA
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Zip | 90038-2610
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Country | US
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Telephone | 323-871-4650
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Fax | 323-463-8141
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 225400000X
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 104324
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License Number State | CA
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