1427514793 NPI number — NYKIAH SUZANNE WALKER FRANK ESPINOZA

Table of content: NYKIAH SUZANNE WALKER FRANK ESPINOZA (NPI 1427514793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427514793 NPI number — NYKIAH SUZANNE WALKER FRANK ESPINOZA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
NYKIAH
Provider Middle Name:
SUZANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FRANK ESPINOZA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WALKER
Provider Other First Name:
NYKIAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427514793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6829 HEMP CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93536-3817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-547-6187
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23502 LYONS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWHALL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91321-2535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-702-0166
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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