Dominique Walker

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17331 Issued in CA

Practice address

1147 Hartnell Ave
Redding, CA 96002-2113

Phone

(530) 222-7213

Fax

(530) 222-7268

NPI assigned

Feb 27, 2024

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Canoga Park, CA
  • NPI 1831601764
  NPD (past)

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1407612328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 HARTNELL AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022113",
            "telephone_number": "530-222-7213",
            "fax_number": "530-222-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 HARTNELL AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022113",
            "telephone_number": "530-222-7213",
            "fax_number": "530-222-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "17331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #05699)
• Walgreen Co (Walgreens #04243)
• Walgreen Co (Walgreens #05781)
• Allie Renee Walker
• Allison Walker, IMF
• Maricela N Walker
• Michelle L Walker, LCSW 79456
• Susan M Walker, OTR/L
• Wayne D Walker
• Amanda Wall

• Addiction (Substance Use Disorder) Counselor in Redding, CA
• Providers in Redding, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.