Provider Demographics
NPI:1518231083
Name:WALKER, JILL SUZANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:SUZANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 BUNKER HILL WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6006
Mailing Address - Country:US
Mailing Address - Phone:831-796-1271
Mailing Address - Fax:
Practice Address - Street 1:1611 BUNKER HILL WAY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-6004
Practice Address - Country:US
Practice Address - Phone:831-796-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical