Individual provider Active NPI

Michael Thomas Walker, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1427134915
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 13954 Issued in CA
Practice address
3751 Stocker St
Los Angeles, CA 90008-5101
Phone
(323) 298-3687
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 13954 CA Primary

Addresses

Primary practice location

3751 Stocker St
Los Angeles, CA 90008-5101

Mailing address

3751 Stocker St
Los Angeles, CA 90008-5101
Phone (323) 298-3687

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050505000421 CA Practitioner - Clinical Psychologist 1951341304 Reassigns benefits to 1 organization
Practice locations: El Segundo, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

877 N Douglas St
El Segundo, CA 90245-2801
Phone (310) 617-5538

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 13954CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Dec 31, 1991 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Dec 31, 1991 Accepting new patients
Megan Sullaway and Edward Dunbar Past Accepting new patients

Locations

921 E Compton Blvd
Compton, CA 90221
Phone (310) 668-6800

921 E Compton Blvd
Fl 1
Compton, CA 90221
Phone (310) 668-6800

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

3741 Stocker St
Ste 200
View Park, CA 90008
Phone (323) 290-5800

3751 Stocker St
View Park, CA 90008
Phone (323) 298-3680

Organizations & group practices 4

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427134915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 STOCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085101",
            "telephone_number": "323-298-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 STOCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085101",
            "telephone_number": "323-298-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 13954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.