Provider Demographics
NPI:1265318174
Name:WALKER, EBONY LASHAWN AURORA
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:LASHAWN AURORA
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-1626
Mailing Address - Country:US
Mailing Address - Phone:510-388-1093
Mailing Address - Fax:
Practice Address - Street 1:1117 S GRANT ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-1626
Practice Address - Country:US
Practice Address - Phone:510-388-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist