Provider Demographics
NPI:1154842177
Name:WALSH, CATHLEEN NOEL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:NOEL
Last Name:WALSH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:C.
Other - Middle Name:NOEL
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:815 E LONGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5446
Mailing Address - Country:US
Mailing Address - Phone:1626-802-7052
Mailing Address - Fax:
Practice Address - Street 1:815 E. LONGDEN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006
Practice Address - Country:US
Practice Address - Phone:1626-802-7052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN424947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN424947OtherBOARD OF REGISTERED NURSING