Individual provider Active NPI

Cinthia Irene Walker, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1104548403
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021309 Issued in CA
Practice address
1401 N El Camino Real Ste 100
San Clemente, CA 92672-4983
Phone
(858) 522-0145
NPI assigned
Sep 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021309 CA Primary

Addresses

Primary practice location

1401 N El Camino Real Ste 100
San Clemente, CA 92672-4983

Mailing address

17427 Wellfleet Ave
Carson, CA 90746-1656
Phone (323) 326-4160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715002212 CA Practitioner - Nurse Practitioner 4981149986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Health Services IncGroup PAC ID 1355748021, 32 clinicians

Practice addresses (Care Compare)

1500 Rosecrans Ave
Suite 500
Manhattan Beach, CA 90266-3771
Phone (310) 360-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Health Services Inc CurrentSince Jul 1, 2024 Accepting new patients
Stephens Medical Corporation CurrentSince Jul 1, 2024 Accepting new patients
Brittany Watson NP Nursing Corporation Psychiatric/Mental Health CurrentSince Jun 4, 2023 Accepting new patients

Locations

320 Pine Ave
Ste 1030
Long Beach, CA 90802
Phone (310) 360-7200

11400 W Olympic Blvd
Ste 200
Los Angeles, CA 90064
Phone (401) 359-0757

1590 Rosecrans Ave
Ste D617
Manhattan Beach, CA 90266
Phone (310) 360-7200

1500 Rosecrans Ave
Ste 500
Manhattan Beach, CA 90266
Phone (310) 571-5936

1401 N El Camino Real
Ste 100
San Clemente, CA 92672
Phone (858) 522-0145

402 W Broadway
Fl 4
San Diego, CA 92101

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1104548403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17427 WELLFLEET AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461656",
            "telephone_number": "323-326-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N EL CAMINO REAL STE 100",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724983",
            "telephone_number": "858-522-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CINTHIA",
        "middle_name": "IRENE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.