Provider Demographics
NPI:1285004028
Name:WALKER, KATHRYN (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3309
Mailing Address - Country:US
Mailing Address - Phone:714-310-5100
Mailing Address - Fax:714-637-8864
Practice Address - Street 1:3851 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3309
Practice Address - Country:US
Practice Address - Phone:714-310-5100
Practice Address - Fax:714-637-8864
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT94179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist