MS. SHARMILA RAEVETTE WALLACE


Address: 5425 Holland St Apt 3, Oakland, CA 94601-5742
Phone: 5105333627

MS. SHARMILA RAEVETTE WALLACE (NPI# 1609057389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609057389
Entity Type Individual
Full Name MS. SHARMILA RAEVETTE WALLACE
Credential BA
Practice Address 5425 Holland St Apt 3
Oakland
CA 94601-5742
Practice Telephone 5105333627
Mailing Telephone 5105333627
Enumeration Date 2007-11-21
Last Update Date 2007-11-21
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TF0200X Psychologist
Specialization: Forensic
Behavioral Health & Social Service Providers

Office Location

Street Address 5425 HOLLAND ST APT 3
City OAKLAND
State CA
Zip Code 94601-5742

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Taxonomy Information

Taxonomy Code 103TF0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Forensic

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467740373 Elizabeth Tang-liang Psychologist 510 16th Street, Oakland, CA 94577 2011-07-12
1609929652 Robert Sargent Psychologist 4374 Norton Ave, Oakland, CA 94602-3541 2007-01-20
1033294509 Paul S. D. Berg Psychologist 400 29th St Ste 315, Oakland, CA 94609-3548 2006-10-25
1356871446 Inka Kristiina Hanhivaara Psychologist 1440 Broadway Ste 314, Oakland, CA 94612-2023 2017-06-12
1023364346 Lauren Kristin Collins Psychologist 519 17th St, Suite # 210, Oakland, CA 94612-1527 2012-07-25
1619222924 Allyson Vincent Psychologist 1440 Broadway, Oakland, CA 94612-2041 2012-07-24
1669727202 Sarah Stephenson Evans Psychologist 1440 Broadway, Oakland, CA 94612-2041 2012-07-19
1114214368 Melissa Anne Murphy Psychologist 1440 Broadway, Suite 610, Oakland, CA 94612-2041 2011-07-07
1407171580 Charles Meyers Psychologist 445 Bellevue Ave, Suite 201, Oakland, CA 94610-4923 2010-04-01
1003059593 Joan Jersey Ponath Psychologist 1515 Clay St Fl 10, Oakland, CA 94612-1499 2009-04-13
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Competitor

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City OAKLAND
Zip Code 94601

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Dataset Information

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.

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