Provider Demographics
NPI:1821278540
Name:WALKER, ANABELLE LAROZA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANABELLE
Middle Name:LAROZA
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 S BRISTOL ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6233
Mailing Address - Country:US
Mailing Address - Phone:714-979-5734
Mailing Address - Fax:714-979-5781
Practice Address - Street 1:2740 S BRISTOL ST STE 208
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6233
Practice Address - Country:US
Practice Address - Phone:714-979-5734
Practice Address - Fax:714-979-5781
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 19193363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA19193Medicaid