Provider Demographics
NPI:1124179650
Name:WALKER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 ELLWOOD BEACH DR
Mailing Address - Street 2:#12
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2762
Mailing Address - Country:US
Mailing Address - Phone:805-637-6369
Mailing Address - Fax:
Practice Address - Street 1:222 W VALERIO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2930
Practice Address - Country:US
Practice Address - Phone:805-682-9917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor