Provider Demographics
NPI:1831738020
Name:WALKER, JESSICA VICTORIA (MS)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:VICTORIA
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:VICTORIA
Other - Last Name:OLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3027 SAN DIEGO RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3691
Mailing Address - Country:US
Mailing Address - Phone:904-493-8326
Mailing Address - Fax:
Practice Address - Street 1:3027 SAN DIEGO RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3691
Practice Address - Country:US
Practice Address - Phone:904-493-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health