Individual
BETTY DERRELLENE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3800 JANES RD, ARCATA, CA 95521-4742
(925) 225-5837
(925) 225-5838
Mailing address
323 E MATILIJA ST, #110, OJAI, CA 93023-2740
(805) 208-5420
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G23506
CA
207Q00000X
Family Medicine Physician
G23506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G235060
—
CA
Enumeration date
05/30/2006
Last updated
04/10/2019
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