Provider Demographics
NPI:1891095600
Name:WALKER, TIMOTHY AARON
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:AARON
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 1:6850 VAN NUYS BLVD
Mailing Address - Street 2:125
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4640
Mailing Address - Country:US
Mailing Address - Phone:818-908-1740
Mailing Address - Fax:
Practice Address - Street 1:6850 VAN NUYS BLVD
Practice Address - Street 2:125
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4640
Practice Address - Country:US
Practice Address - Phone:818-908-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)