Maya Denise Walls, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

551614 Issued in CA

Practice address

4290 Polk Ave
San Diego, CA 92105-1524

Phone

(691) 563-0507

Fax

(691) 563-0015

NPI assigned

Aug 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467460220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051524",
            "telephone_number": "691-563-0507",
            "fax_number": "691-563-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051524",
            "telephone_number": "691-563-0507",
            "fax_number": "691-563-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "MAYA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "551614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "551614",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Wallis
• Marina Wallis
• Ryan Young Wallrich, D.M.D.
• David Allen Walls, MFCC
• Halle Walls, MD
• Gary Wallum, COTA/L
• Walmart Inc (Walmart Vision Center 30-5938)
• Walmart Inc. (WalMart Pharmacy 10-5938)
• Walmart Inc. (Walmart Pharmacy 10-2479)
• Walmart Inc. (Walmart Pharmacy 10-2150)

• Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.