Individual provider Active NPI

Desiree Louise Spencer-Walters

  • Registered Nurse
  • Valencia, CA
National Provider Identifier
1124667167
Registry record updated Dec 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
651028 Issued in CA
Practice address
23845 McBean Pkwy
Valencia, CA 91355-2001
Phone
(661) 200-1083
Fax
(661) 200-1076
NPI assigned
Dec 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 651028 CA Primary

Addresses

Primary practice location

23845 McBean Pkwy
Valencia, CA 91355-2001

Mailing address

19533 Ellis Henry CT
Newhall, CA 91321-2152
Phone (661) 414-5269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
651028CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1124667167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19533 ELLIS HENRY CT",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212152",
            "telephone_number": "661-414-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23845 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552001",
            "telephone_number": "661-200-1083",
            "fax_number": "661-200-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER-WALTERS",
        "first_name": "DESIREE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-21",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "651028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.