Provider Demographics
NPI:1346328861
Name:WALKER, TAMMIE LASHAUN (BS,CTRS, RTC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:LASHAUN
Last Name:WALKER
Suffix:
Gender:F
Credentials:BS,CTRS, RTC
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:
Other - Last Name:LODON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 E DUARTE RD
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3948
Mailing Address - Country:US
Mailing Address - Phone:626-294-0766
Mailing Address - Fax:
Practice Address - Street 1:16111 PLUMMER ST
Practice Address - Street 2:
Practice Address - City:SEPULVEDA
Practice Address - State:CA
Practice Address - Zip Code:91343-2036
Practice Address - Country:US
Practice Address - Phone:818-891-7711
Practice Address - Fax:818-895-5817
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53010225800000X
CA4070-T225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist