Provider Demographics
NPI:1629653472
Name:WALKER, CASSANDRA MAE (DC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MAE
Last Name:WALKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 E AVENUE S14
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-2308
Mailing Address - Country:US
Mailing Address - Phone:323-740-2505
Mailing Address - Fax:
Practice Address - Street 1:2211 CORINTH AVE STE 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1622
Practice Address - Country:US
Practice Address - Phone:310-481-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor