MS. JENNIFER WALLACE (NPI# 1356968440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356968440 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER WALLACE |
| Practice Address |
2041 E 3rd Dr Mesa AZ 85204-1401 |
| Practice Telephone | 4806857530 |
| Mailing Telephone | 4806857530 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist | $$$$$$$$$ | AZ | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1699760934 | Jennifer L Wallace | Internal Medicine | 7720 Jones Maltsberger, Suite 110, San Antonio, TX 78216 | 2005-09-13 |
| Street Address |
2041 E 3RD DR |
| City | MESA |
| State | AZ |
| Zip Code | 85204-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 156F00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| A broad category grouping different kinds of technologists and technicians. See individual definitions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306402771 | Evan Klees | Technician/Technologist | 1237 E Dust Devil Dr, San Tan Valley, AZ 85143-4287 | 2019-05-11 |
| 1750854071 | E3 Network, Inc. | Technician/Technologist | 14780 W Mountain View Blvd Bldg Suite110, Surprise, AZ 85374-4799 | 2019-01-09 |
| 1275706939 | Haneelia Jean Max | Technician/Technologist | 322 Hwy 160, Suite #13, Tuba City, AZ 86045-2489 | 2008-04-02 |
| 1275155848 | Richard Hernandez | Technician/Technologist | 3269 N Stockton Hill Rd, Kingman, AZ 86409-3619 | 2020-05-17 |
| 1598237315 | Diego Abraham Chavez | Technician/Technologist | 1 S Church Ave Ste 1200, Tucson, AZ 85701-1601 | 2018-12-18 |
| 1962828632 | Laura P Reyes | Technician/Technologist | 1750 E Glendale Ave, Phoenix, AZ 85020-5505 | 2014-03-05 |
| 1336430719 | Patrina Ashiking | Technician/Technologist | 167 N Main Street, Tuba City, AZ 86045 | 2011-04-20 |
| 1043501422 | Janie Peaches | Technician/Technologist | 167 North Main Street, Optometry Dept, Tuba City, AZ 86045-0600 | 2011-04-20 |
| 1053602433 | Angela L. Kiyaani | Technician/Technologist | 167 N. Main St., Tuba City, AZ 86045-0600 | 2011-04-20 |
| 1003136102 | Diandra Marlene Martinez | Technician/Technologist | 12033 Agency Road, Parker, AZ 85344 | 2010-06-11 |
| Find all providers with the same taxonomy | ||||
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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.