Provider Demographics
NPI:1780907865
Name:BEBB-WALKER, SYDNEY ANNETTE (LAC)
Entity type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:ANNETTE
Last Name:BEBB-WALKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:SYDNEY
Other - Middle Name:ANNETTE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:5180 SONOMA MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-8881
Mailing Address - Country:US
Mailing Address - Phone:707-544-8802
Mailing Address - Fax:707-544-8802
Practice Address - Street 1:1205 GRAVENSTEIN HWY S
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4851
Practice Address - Country:US
Practice Address - Phone:707-217-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA3545171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist