Provider Demographics
NPI:1760602924
Name:WALKER, LOUISE PHINIZY (MFT)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:PHINIZY
Last Name:WALKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 OAK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1000
Mailing Address - Country:US
Mailing Address - Phone:530-758-3178
Mailing Address - Fax:530-753-0636
Practice Address - Street 1:1621 OAK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1000
Practice Address - Country:US
Practice Address - Phone:530-758-3178
Practice Address - Fax:530-753-0636
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#14382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist