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Provider Information for 1790988699


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Ms. XANTHIPPE B. WALKER M.F.T., R.A.S., A.T.


Sex: Female

NPI: 1790988699
Last Updated: 2022-02-11
Certification Date:

Details

NameValue
NPI1790988699
Enumeration Date2007-06-07
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1585 62ND ST
SUITE 8039
EMERYVILLE, CA 94662-7099
United States

Phone: 510-859-4407 | Fax:510-547-8923
 
Primary Practice Address 15970 E 14TH ST
SUITE 4
SAN LEANDRO, CA 94578-3018
United States

Phone: 510-859-4407 | Fax:510-547-8923
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
SOAP URL
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Carequality
Health Information Exchange (HIE) C-CDA The Permanente Medical Group 1201 Fillmore St
San Francisco, CA 94115
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)CAW0501030745
Yes 106H00000X - Marriage & Family Therapist CA52865