Provider Demographics
NPI:1053618181
Name:WALTON, JAMES EDGAR (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDGAR
Last Name:WALTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 RIVERSIDE DR
Mailing Address - Street 2:SUITE 318
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2500
Mailing Address - Country:US
Mailing Address - Phone:818-753-4865
Mailing Address - Fax:818-753-4865
Practice Address - Street 1:13400 RIVERSIDE DR
Practice Address - Street 2:SUITE 318
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2500
Practice Address - Country:US
Practice Address - Phone:818-753-4865
Practice Address - Fax:818-753-4865
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist