Dr. Mary E. Walker Center

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

218428 Issued in CA

Legal business name

DR. MARY E. WALKER CENTER

Practice address

5306A Gopher LN
Fort Irwin, CA 92310-2205

Phone

(760) 386-3290

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Ladesca Dawn Smith, LPN

Title

LPN

Phone

(760) 386-3290

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497834840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306A GOPHER LN",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102205",
            "telephone_number": "760-386-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306A GOPHER LN",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102205",
            "telephone_number": "760-386-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARY E. WALKER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LADESCA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "760-386-3290",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "CA",
            "license": "218428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johelen Erika Dominicci, RN
• Crystal G Donders, DO
• Elia Donnelly, LCSW
• Shawna Jeanett Downs, DENTAL ASSISTANT
• Dr Caroline Z Kristo PHD
• Sarah Elizabeth Dugan, RN
• Adam Bailey Duncan, DO
• Leila Durant
• Darnell Autry Durrah Jr., PHD
• Elsie Pearl Ursua Dy

• Physical Disabilities Residential Treatment Facility in Fort Irwin, CA
• Providers in Fort Irwin, CA by specialty
• Physical Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.