Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | HAP217 | CA |
N | 124Q00000X | Dental Hygienist | RDH20986 | CA |
NPI | 1043542640 |
---|---|
Provider Name | Ms. Sharon Lenore Walker |
First Address | San Diego, CA 92101-4300 |
Second Address | San Diego, CA 92101-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 20/11/2013 |