Henery Waller Jr., MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21413 Issued in CA

Practice address

18031 US Highway 18
Suite F
Apple Valley, CA 92307-2152

Phone

(760) 242-1300

Fax

(760) 242-1331

NPI assigned

Jun 23, 2011

Last updated

Jun 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1144516519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18",
            "address_2": "SUITE F",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18",
            "address_2": "SUITE F",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152",
            "telephone_number": "760-242-1300",
            "fax_number": "760-242-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "HENERY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariya Heaven Walker, HIGH SCHOOL DIPLOMA
• Krystal Walker
• Robert Henry Walker, R.P.T.
• Terrie Walker
• Phillip Wallace, PPS
• Steven B Wallis, OD
• Walmart Inc. (Walmart Pharmacy 10-2333)
• Letricia Ladiamond Walton, LVN
• Janet Anne Warren, NP
• Miesha Warren

• Clinical Social Worker in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.