Provider Demographics
NPI:1932577038
Name:WALKER, ESTRELLA (RD)
Entity Type:Individual
Prefix:MRS
First Name:ESTRELLA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:ESTRELLA
Other - Middle Name:
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:24123 FIR AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-2837
Mailing Address - Country:US
Mailing Address - Phone:951-374-3710
Mailing Address - Fax:
Practice Address - Street 1:6809 INDIANA AVE
Practice Address - Street 2:STE #130-A55
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4221
Practice Address - Country:US
Practice Address - Phone:951-374-3710
Practice Address - Fax:951-231-1501
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1067219133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered