Individual provider Active NPI

Raelene Walker, M.D.

  • Pediatrics Physician
  • Santa Cruz, CA
National Provider Identifier
1235255811
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A60962 Issued in CA
Practice address
1510 Capitola Rd
Santa Cruz, CA 95062-2912
Phone
(831) 427-3500
NPI assigned
Mar 22, 2007
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A60962 CA Primary

Addresses

Primary practice location

1510 Capitola Rd
Santa Cruz, CA 95062-2912

Mailing address

PO Box 542
Santa Cruz, CA 95061-0542

Other practice location 1

2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone (831) 458-5845

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150904002532 CA Practitioner - Pediatric Medicine 8820304892 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A60962CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. CurrentSince Jul 11, 2025 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Jul 11, 2025 Accepting new patients
Yale New Haven Hospital Past Accepting new patients
Watsonville Hospital Corporation Past Accepting new patients
Santa Cruz Community Health Centers Past Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 468-1010

Interoperability endpoints

  • Direct secure messaging: rwalker101753@hisp.ehr.sutterhealth.org
  • Direct secure messaging: rwalker845566@direct.ochin.org

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1235255811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950610542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 CAPITOLA RD",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622912",
            "telephone_number": "831-427-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Soquel Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950621323",
            "country_code": "US",
            "telephone_number": "831-458-5845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "RAELENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A60962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.