Provider Demographics
NPI:1790988699
Name:WALKER, XANTHIPPE B (MFT, RAS, AT)
Entity Type:Individual
Prefix:MS
First Name:XANTHIPPE
Middle Name:B
Last Name:WALKER
Suffix:
Gender:F
Credentials:MFT, RAS, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 62ND ST
Mailing Address - Street 2:SUITE 8039
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94662-7099
Mailing Address - Country:US
Mailing Address - Phone:510-859-4407
Mailing Address - Fax:510-547-8923
Practice Address - Street 1:15970 E 14TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-3018
Practice Address - Country:US
Practice Address - Phone:510-859-4407
Practice Address - Fax:510-547-8923
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAW0501030745101YA0400X
CA52865106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)