Individual ProviderIna Marie WaltsPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9285 Sierra College Blvd, Roseville, CA 95661-5919(916) 784-3376PECOS EnrollmentBased on the most recent information from CMS, provider Ina Marie Walts does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1215032354Provider TypeIndividualFull NameWalts, Ina MarieTitleMrs.CredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date9/13/2006Last Updated5/25/2010Contact InformationPractice LocationPractice Address9285 Sierra College Blvd, Roseville, CA 95661-5919Phone(916) 784-3376FaxUnlisted FaxMailing LocationMailing Address9285 Sierra College Blvd, Roseville, CA 95661-5919Phone(916) 784-3376FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA17683California