Provider Demographics
NPI:1629293345
Name:WALKER, DARREN
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93483-0336
Mailing Address - Country:US
Mailing Address - Phone:805-481-1523
Mailing Address - Fax:805-481-1269
Practice Address - Street 1:935 RIVERSIDE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2653
Practice Address - Country:US
Practice Address - Phone:805-481-1523
Practice Address - Fax:805-481-1269
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAD2723237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAD2723OtherSTATE LICENSE