Provider Demographics
NPI:1033376322
Name:WALKER, LISA CHRISTINE (MCLSC, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:CHRISTINE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MCLSC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 COLLIER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1902
Mailing Address - Country:US
Mailing Address - Phone:858-220-8467
Mailing Address - Fax:619-278-0885
Practice Address - Street 1:3731 6TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4383
Practice Address - Country:US
Practice Address - Phone:619-694-6579
Practice Address - Fax:619-278-0885
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist