Provider Demographics
NPI:1548515877
Name:WALTERS, HELENE (MD)
Entity type:Individual
Prefix:DR
First Name:HELENE
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HELENE
Other - Middle Name:
Other - Last Name:SMEDTS WALTERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6100 REDWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-4501
Mailing Address - Country:US
Mailing Address - Phone:415-448-1500
Mailing Address - Fax:415-798-3196
Practice Address - Street 1:6100 REDWOOD BLVD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-4501
Practice Address - Country:US
Practice Address - Phone:415-448-1500
Practice Address - Fax:415-798-3196
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 122115208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics