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Individual
MS. KIMBERLY RENEE WALKER
Active
Individual
MS. KIMBERLY RENEE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14331TPG
CA
152WP0200X
Pediatric Optometrist
14331TPG
CA
152WV0400X
Vision Therapy Optometrist
14331TPG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FY138Z
MEDICARE PTAN SO CAL
CA
Enumeration date
01/27/2006
Last updated
05/17/2018
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