Provider Demographics
NPI:1528286234
Name:WALKER, WARREN R (PHD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:R
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 HAMPSHIRE RD
Mailing Address - Street 2:STE. 215
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2379
Mailing Address - Country:US
Mailing Address - Phone:805-497-3155
Mailing Address - Fax:805-371-4875
Practice Address - Street 1:699 HAMPSHIRE RD
Practice Address - Street 2:STE. 215
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2379
Practice Address - Country:US
Practice Address - Phone:805-497-3155
Practice Address - Fax:805-371-4875
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4892103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA202937559Medicare UPIN