Active NPI
Jacquelyn Martin Walker, M.D.
- Adult Medicine Physician
- Pasadena, CA
National Provider Identifier
1770829301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- C40096
- Practice address
- 831 S El Molino Ave
Pasadena, CA 91106-4411 - Phone
- (626) 795-8495
- Fax
- (626) 449-6440
- NPI assigned
- Jan 1, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | C40096 | CA | Primary |
Addresses
Primary practice location
831 S El Molino Ave
Pasadena, CA 91106-4411
Mailing address
831 S El Molino Ave
Pasadena, CA 91106-4411
Phone (626) 795-8495
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C40096 | Other | CA | MEDICAL BOARD OF CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C40096 | CA | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356998400000",
"number": "1770829301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "831 S EL MOLINO AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911064411",
"telephone_number": "626-795-8495",
"fax_number": "626-449-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 S EL MOLINO AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911064411",
"telephone_number": "626-795-8495",
"fax_number": "626-449-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JACQUELYN",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-01",
"last_updated": "2013-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CA",
"license": "C40096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD OF CA",
"identifier": "C40096",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.