Provider Demographics
NPI:1891844726
Name:STANTON, WALTER EDWARD II (RN)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:EDWARD
Last Name:STANTON
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:WALT
Other - Middle Name:
Other - Last Name:STANTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1010 EASUM DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-5525
Mailing Address - Country:US
Mailing Address - Phone:707-253-4727
Mailing Address - Fax:707-259-8344
Practice Address - Street 1:2344 OLD SONOMA RD
Practice Address - Street 2:BLDG. D
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3708
Practice Address - Country:US
Practice Address - Phone:707-253-4727
Practice Address - Fax:707-259-8344
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445703163WP0807X, 163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult