Provider Demographics
NPI:1073713624
Name:WALKER, DAVID TERRENCE
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:TERRENCE
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COLEMAN PL APT E
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2426
Mailing Address - Country:US
Mailing Address - Phone:650-921-1055
Mailing Address - Fax:
Practice Address - Street 1:2 COLEMAN PL APT E
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-2426
Practice Address - Country:US
Practice Address - Phone:650-921-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health