Provider Demographics
NPI:1427514793
Name:WALKER, NYKIAH SUZANNE (FRANK ESPINOZA)
Entity type:Individual
Prefix:
First Name:NYKIAH
Middle Name:SUZANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:FRANK ESPINOZA
Other - Prefix:
Other - First Name:NYKIAH
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6829 HEMP CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-3817
Mailing Address - Country:US
Mailing Address - Phone:661-547-6187
Mailing Address - Fax:
Practice Address - Street 1:23502 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2535
Practice Address - Country:US
Practice Address - Phone:661-702-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty