JENNIFER WALLACE (NPI# 1205483849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205483849 |
| Entity Type | Individual |
| Full Name | JENNIFER WALLACE |
| Practice Address |
320 E Palmdale Blvd Palmdale CA 93550-4598 |
| Mailing Address |
43415 20th St W Apt 21 Lancaster CA 93534-5964 |
| Practice Telephone | 6617299000 |
| Mailing Telephone | 6617541550 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CI21770419 | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1295083897 | Jennifer Wallace | Psychologist | 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 | 2012-08-29 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| Street Address |
320 E PALMDALE BLVD |
| City | PALMDALE |
| State | CA |
| Zip Code | 93550-4598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427189232 | Christina Hesselbrock | Social Worker | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2007-03-07 |
| 1336763978 | Joseph Munoz | Counselor | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2020-05-29 |
| 1811518582 | Alfonso Lopez Jr. | Counselor | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2020-05-04 |
| 1912532219 | Roberta Price | Licensed Vocational Nurse | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2020-03-06 |
| 1952935470 | Cristina Stowe | Case Manager/Care Coordinator | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2020-02-24 |
| 1851930291 | Christina Ramirez | Social Worker | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2020-01-02 |
| 1033757935 | Antonia M Rocha | Counselor | 320 E Palmdale Blvd, Palmdale, CA 93550 | 2019-12-11 |
| 1215599485 | Gregory Glen Maxwell | Marriage & Family Therapist | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2019-07-08 |
| 1437668886 | Amy Christina Martinez | Marriage & Family Therapist | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2017-09-28 |
| 1285930396 | Tarzana Treatment Centers, Inc. | Clinic/Center | 320 E Palmdale Blvd, Palmdale, CA 93550-4598 | 2011-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612118 | Well Care Hospice Inc | Hospice Care, Community Based | 1543j East Palmdale Blvd., Palmdale, CA 93550 | 2020-09-03 |
| 1922565522 | California Recuperative Care, Inc | Social Worker | 38529 6th St. East, Palmdale, CA 93550 | 2019-03-01 |
| 1649751777 | Earl Larry Hernandez | Rehabilitation Practitioner | 1609 East Palmdale Blvd Suite G, Palmdale, CA 93550 | 2018-08-27 |
| 1265940050 | Virginia Alvarez | Counselor | 3058 East Aver14, Palmdale, CA 93550 | 2018-01-16 |
| 1225553498 | Natalie Christine Ragus | Social Worker | 1529 E. Palmdale Blvd. Ste 150, Palmdale, CA 93550 | 2017-08-09 |
| 1104348770 | Purificacion Paguyo Villegas | Registered Nurse | 38350 40th St East, 2nd Floor, Palmdale, CA 93550 | 2017-07-14 |
| 1528580438 | Perla Marilyn Rodriguez | Registered Nurse | 38350 40th St East, Palmdale, CA 93550 | 2017-07-12 |
| 1992259527 | Nathalie Exconde | Counselor | 1529 East Palmdale Blvd Suite 150, Palmdale, CA 93550 | 2016-08-11 |
| 1083064604 | Sinead Diaz | Community Health Worker | 2323a East Palmdale Boulvard, Palmdale, CA 93550 | 2016-06-14 |
| 1598122293 | Sharnelle Denise Patterson | Rehabilitation Practitioner | 2010 Moonflower Ct, Palmdale, CA 93550 | 2016-01-26 |
| Find all providers in zip 93550 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376106906 | Arelettia Nell Jones | Counselor | 37524 Sharon Ln, Palmdale, CA 93552-4466 | 2019-04-18 |
| 1407346463 | Marva Lasean Britton | Counselor | 38739 5th St E Apt 1, 1, Palmdale, CA 93550-3774 | 2018-05-15 |
| 1821587528 | George Moreno | Counselor | 40356 Nido Ct, Palmdale, CA 93551-5225 | 2018-05-08 |
| 1265940050 | Virginia Alvarez | Counselor | 3058 East Aver14, Palmdale, CA 93550 | 2018-01-16 |
| 1972014629 | Maria Gutierrez | Counselor | 38124 Lido Dr, Palmdale, CA 93552-3208 | 2017-10-21 |
| 1326562448 | Silvia Carolina Self | Counselor | 1025 E Avenue Q5 Apt 11, Palmdale, CA 93550-2900 | 2017-07-31 |
| 1144756081 | Chemika Jones | Counselor | 5736 Finchley Rd, Palmdale, CA 93552-5470 | 2017-05-11 |
| 1831622661 | Cynthia Tiscareno | Counselor | 4326 Avoca Ave, Palmdale, CA 93552-5121 | 2017-04-08 |
| 1316134224 | Kimya Abdul-jabbar | Counselor | 2720 E Palmdale Blvd Ste 129, Palmdale, CA 93550-4930 | 2007-09-25 |
| 1285855213 | Sherrie Lyn Crisp | Counselor | 1607 E. Palmdale Blvd Suite G, Palmdale, CA 93550 | 2007-05-01 |
| Find all providers in PALMDALE | ||||
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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.