Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A83345 | CA |
N | 208000000X | Pediatrician | A83345 | CA |
NPI | 1497821763 |
---|---|
Provider Name | Valerie Leigh Watiker |
First Address | Tarzana, CA 91356-4218 |
Second Address | Tarzana, CA 91356-4218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 30/03/2021 |