Provider Demographics
NPI:1972288512
Name:WALKER, JULEEN
Entity Type:Individual
Prefix:
First Name:JULEEN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N GRAND AVE APT 144
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1714
Mailing Address - Country:US
Mailing Address - Phone:626-653-3649
Mailing Address - Fax:
Practice Address - Street 1:200 N GRAND AVE APT 144
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1714
Practice Address - Country:US
Practice Address - Phone:626-653-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician