Provider Demographics
NPI:1255481990
Name:WALKER, ANDREA LYNN (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MAYHEW WAY STE 301
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4398
Mailing Address - Country:US
Mailing Address - Phone:925-890-7718
Mailing Address - Fax:925-279-1219
Practice Address - Street 1:140 MAYHEW WAY STE 301
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4398
Practice Address - Country:US
Practice Address - Phone:925-890-7718
Practice Address - Fax:925-279-1219
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist