DAVID WALLACE (NPI# 1174015499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174015499 |
Entity Type | Individual |
Full Name | DAVID WALLACE |
Credential | BS-SLPA |
Practice Address |
11840 S La Cienega Blvd Hawthorne CA 90250-3459 |
Practice Telephone | 2422693400 |
Practice Fax Number | 3108825451 |
Mailing Telephone | 2422693400 |
Mailing Fax Number | 3108825451 |
Enumeration Date | 2018-06-01 |
Last Update Date | 2020-02-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
3499 | CA | Speech, Language and Hearing Service Providers |
N | 235Z00000X | Speech-Language Pathologist | 3499 | CA | Speech, Language and Hearing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700327061 | David Wallace | Student in an Organized Health Care Education/Training Program | 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 | 2017-03-19 |
1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
1386868487 | David Stuart Wallace | Chiropractor | 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-04-12 |
1649343641 | David Michael Wallace | Chiropractor | 112 W Grand Ave, Rainbow City, AL 35906-3233 | 2006-11-16 |
1932193604 | David Wallace | Anesthesiology | 738 Golden Pheasant Dr, Draper, UT 84020-8454 | 2005-09-08 |
1386646206 | David Allen Wallace | Dentist | 206 S Walker St, Princeton, WV 24740-2747 | 2005-08-11 |
1295736809 | David B. Wallace | Radiology | 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 | 2005-08-04 |
1679576276 | David Alan Wallace | Ophthalmology | 11600 Wilshire Blvd, Ste 200, Los Angeles, CA 90025-1782 | 2005-05-27 |
1619596335 | David Alexander Wallace | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-13 |
1396364402 | David Carter Wallace | Student in an Organized Health Care Education/Training Program | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2020-04-09 |
Street Address |
11840 S LA CIENEGA BLVD |
City | HAWTHORNE |
State | CA |
Zip Code | 90250-3459 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578719472 | Lisa D Murphy | Occupational Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2008-08-11 |
1205444874 | Shuyi Wang | Physical Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2020-07-20 |
1619593720 | Sarah Elena Falcy | Occupational Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2020-06-24 |
1578186375 | Jordyn Pursel | Occupational Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2020-05-27 |
1003458936 | Caitlin Rose Parr | Physical Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-10-11 |
1932761269 | Alexis Mei-li Smith | Speech-Language Pathologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-07-08 |
1356906010 | Kristen Ann Maranan | Physical Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-05-07 |
1366907537 | Napa Center, Inc | Occupational Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-02-01 |
1629533898 | Napa Center, Inc | Speech-Language Pathologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-02-01 |
1811452089 | Napa Center, Inc | Physical Therapist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2019-02-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
Find all providers in zip 90250 |
Taxonomy Code | 2355S0801X |
Grouping | Speech, Language and Hearing Service Providers |
Classification | Specialist/Technologist |
Specialization | Speech-Language Assistant |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245611243 | Amanda Reyes | Specialist/Technologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2015-06-16 |
1295122992 | Jamie Marie Lacroix | Specialist/Technologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2015-04-20 |
1275929028 | Annais Vazquez | Specialist/Technologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2015-04-08 |
1801290705 | Andrea Rutz | Specialist/Technologist | 11840 S La Cienega Blvd, Hawthorne, CA 90250-3459 | 2014-10-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205434552 | Onneka Taitano | Specialist/Technologist | 18743 Pioneer Blvd Ste 203, Artesia, CA 90701-5662 | 2020-10-09 |
1366058505 | Amanda Lauren Ramos Liberto Mcnamara | Specialist/Technologist | 7525 Metropolitan Drive, 308, San Diego, CA 92108-4412 | 2020-09-22 |
1851907679 | Samantha Gutierrez-curran | Specialist/Technologist | 12582 Naples Way, Rancho Cucamonga, CA 91739-2631 | 2020-09-17 |
1912513904 | Jenifer G Camargo | Specialist/Technologist | 11284 Mountain Ave, Riverside, CA 92505-2633 | 2020-09-16 |
1508471186 | Rachael Catherine Stankey | Specialist/Technologist | 7 Seton Ct, Rancho Mirage, CA 92270-3714 | 2020-09-10 |
1104431774 | Andrea Marie Gonzalez | Specialist/Technologist | 1202 Kingsdale Dr, Corona, CA 92878-7708 | 2020-09-10 |
1316551302 | Taylor Kami Hirata | Specialist/Technologist | 21515 Hawthorne Blvd Ste Gl-100, Torrance, CA 90503-6501 | 2020-09-07 |
1811501166 | Carla Rita Rambo | Specialist/Technologist | 14772 Pineline Ave, Chino Hills, CA 91709 | 2020-09-03 |
1205449576 | Blind Children's Learning Center | Specialist/Technologist | 18542 Vanderlip Ave, Santa Ana, CA 92705-8201 | 2020-08-26 |
1922618867 | Jennifer Chan | Specialist/Technologist | 1281 Calle Cecilia, San Dimas, CA 91773-4435 | 2020-08-05 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.