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General NPI Number Information
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NPI Number | 1790988699
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Entity Type | Individual
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Provider Name | XANTHIPPE B. WALKER M.F.T., R.A.S., A.T.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 15970 E 14TH ST SUITE 4
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City | SAN LEANDRO
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State | CA
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Zip | 94578-3018
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Country | US
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Telephone | 510-859-4407
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Fax | 510-547-8923
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Provider Business Mailing Address
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Address Line | 1585 62ND ST SUITE 8039
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City | EMERYVILLE
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State | CA
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Zip | 94662-7099
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Country | US
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Telephone | 510-859-4407
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Fax | 510-547-8923
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | W0501030745
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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 | 52865
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License Number State | CA
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