Provider Demographics
NPI:1902001126
Name:WALKER, ELVIRA C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELVIRA
Middle Name:C
Last Name:WALKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 E PACIFIC COAST HWY # 385
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4201
Mailing Address - Country:US
Mailing Address - Phone:562-225-8315
Mailing Address - Fax:562-597-3563
Practice Address - Street 1:5855 E NAPLES PLZ STE 301
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5091
Practice Address - Country:US
Practice Address - Phone:562-861-9191
Practice Address - Fax:562-597-3563
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21430103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP974BMedicare UPIN