Provider Demographics
NPI:1447716410
Name:WITTE, WALKER (LMFT)
Entity type:Individual
Prefix:
First Name:WALKER
Middle Name:
Last Name:WITTE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E 23RD ST.
Mailing Address - Street 2:#3
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606
Mailing Address - Country:US
Mailing Address - Phone:415-483-5105
Mailing Address - Fax:
Practice Address - Street 1:605 E 23RD ST
Practice Address - Street 2:#3
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1995
Practice Address - Country:US
Practice Address - Phone:415-483-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist