Provider Demographics
NPI:1225155773
Name:WALKER, VANESSA JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:JANE
Last Name:WALKER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1300 ETHAN WAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2211
Mailing Address - Country:US
Mailing Address - Phone:916-482-7623
Mailing Address - Fax:916-488-7432
Practice Address - Street 1:5 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 190
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2865
Practice Address - Country:US
Practice Address - Phone:916-784-7498
Practice Address - Fax:916-786-2715
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-06-28
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00939207R00000X
NVDO1548207R00000X, 208M00000X
CA20A13275207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A13275OtherCA MEDICAL LICENSE
CACA128292Medicare PIN