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General NPI Number Information
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NPI Number | 1871280669
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Entity Type | Individual
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Provider Name | SAMIR WALKMAN PMHNP-BC, MSN, RN
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Gender | Male
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 42923 N FORK DR
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City | THREE RIVERS
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State | CA
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Zip | 93271-9644
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Country | US
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Telephone | 949-561-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 22 ANTIQUE ROSE
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City | IRVINE
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State | CA
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Zip | 92620-4802
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Country | US
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Telephone | 949-561-8720
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95302275
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95033911
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License Number State | CA
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