Provider Demographics
NPI:1518989987
Name:WALKER, STEPHEN BRYANT (MFT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BRYANT
Last Name:WALKER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 ALHAMBRA BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3851
Mailing Address - Country:US
Mailing Address - Phone:916-492-9007
Mailing Address - Fax:916-492-9396
Practice Address - Street 1:708 ALHAMBRA BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3851
Practice Address - Country:US
Practice Address - Phone:916-492-9007
Practice Address - Fax:916-492-9396
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36712106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC36712OtherMARRIAGE & FAMILY THERAPY