Provider Demographics
NPI:1326223587
Name:WALKER, CHRISTINA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 SAN CLEMENTE DR STE B230
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1299
Mailing Address - Country:US
Mailing Address - Phone:415-886-7062
Mailing Address - Fax:
Practice Address - Street 1:45 SAN CLEMENTE DR STE B230
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1299
Practice Address - Country:US
Practice Address - Phone:415-886-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB33236101YM0800X
CAPSY22470103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health