Provider Demographics
NPI:1013790021
Name:WALKER, NATHAN JAMES (PA)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:JAMES
Last Name:WALKER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 S PALISADE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8905
Mailing Address - Country:US
Mailing Address - Phone:805-739-3968
Mailing Address - Fax:805-739-3051
Practice Address - Street 1:116 S PALISADE DR STE 200
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8905
Practice Address - Country:US
Practice Address - Phone:805-739-3968
Practice Address - Fax:805-739-3051
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63612363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant