Active NPI
Michael Claude Walker, PSY.D
- Clinical Psychologist
- Riverside, CA
National Provider Identifier
1497883060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY20652
- Practice address
- 5790 Magnolia Ave
Suite 202
Riverside, CA 92506-1874 - Phone
- (909) 229-1253
- Fax
- (951) 781-1303
- NPI assigned
- Mar 2, 2007
- Last updated
- Mar 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY20652 | CA | Primary |
Addresses
Primary practice location
5790 Magnolia Ave
Suite 202
Riverside, CA 92506-1874
Mailing address
5790 Magnolia Ave
Suite 202
Riverside, CA 92506-1874
Phone (909) 229-1253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20652 | Other | CA | LICENSE NUMBER |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120519000049 | CA | Practitioner - Clinical Psychologist | 4789847245 | Practice locations: Riverside, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Loma Linda University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5790 Magnolia Ave
Riverside, CA 92506-1874
Phone (909) 229-1253
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY20652 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330992000000",
"number": "1497883060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5790 MAGNOLIA AVE",
"address_2": "SUITE 202",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925061874",
"telephone_number": "909-229-1253",
"fax_number": "951-781-1303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5790 MAGNOLIA AVE",
"address_2": "SUITE 202",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925061874",
"telephone_number": "909-229-1253",
"fax_number": "951-781-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "MICHAEL",
"middle_name": "CLAUDE",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2012-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20652",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "20652",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.