JEANNIE WALLACE (NPI# 1699328492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699328492 |
| Entity Type | Individual |
| Full Name | JEANNIE WALLACE |
| Credential | PHD |
| Practice Address |
16055 Ventura Blvd Ste 728 Encino CA 91436-2610 |
| Practice Telephone | 8185015590 |
| Mailing Telephone | 8185015590 |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2019-07-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
MFT18882 | CA | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | MFT18882 | CA | Behavioral Health & Social Service Providers |
| Street Address |
16055 VENTURA BLVD STE 728 |
| City | ENCINO |
| State | CA |
| Zip Code | 91436-2610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417584475 | Antoinette De Leon | Marriage & Family Therapist | 16055 Ventura Blvd Ste 728, Encino, CA 91436-2610 | 2020-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405014 | Find Your Balance, Center for Growth & Change Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Suite 603, Encino, CA 91436 | 2020-07-24 |
| 1396214482 | Maria Guadalupe Cruz | Behavior Technician | 16500 Ventura Blvd # 414, Encino, CA 91436 | 2018-11-19 |
| 1699277186 | Rodolfo Alavez Jimenez | Behavior Technician | 16500 Ventura Blvd., Suite 414, Encino, CA 91436 | 2018-03-01 |
| 1750891503 | Robert James Kim-farley | Preventive Medicine | 4037 Rogen Drive, Encino, CA 91436 | 2017-10-06 |
| 1528577871 | Julia Szpakiewicz | Marriage & Family Therapist | 16550 Ventura Blvd 318, Encino, CA 91436 | 2017-09-28 |
| 1457875452 | Jeffrey Proniloff | Dentist | 16680 Ashley Oaks, Encino, CA 91436 | 2017-08-01 |
| 1114449592 | Loren Lizeth Huerta | Specialist/Technologist | 16500 Ventura Blvd #414, Encino, CA 91436 | 2017-07-07 |
| 1538619838 | Gilbert Torres Jr. | Physical Therapist | 16260 Ventura Blvd # 600, Encino Medical Tower, Encino, CA 91436 | 2016-10-11 |
| 1417313529 | Nancy L Reynolds | Marriage & Family Therapist | 16055 Ventura Blvd #409, Encino, CA 91436 | 2016-01-05 |
| 1457716748 | Salvador Salgado | Behavioral Analyst | 16500 Ventura Blvd. Suite 414, Encino, CA 91436 | 2015-12-31 |
| Find all providers in zip 91436 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497356398 | Lourdes Loyola | Marriage & Family Therapist | 15720 Ventura Blvd Ste 603, Encino, CA 91436-4727 | 2020-11-06 |
| 1801405014 | Find Your Balance, Center for Growth & Change Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Suite 603, Encino, CA 91436 | 2020-07-24 |
| 1548883341 | Kerry Ann Mclean | Marriage & Family Therapist | 1777 Ventura Blvd Unit 103, Encino, CA 91316 | 2020-05-27 |
| 1073157434 | Amy Beth Griego | Marriage & Family Therapist | 17950 Burbank Blvd Apt 17, Encino, CA 91316-1673 | 2019-10-29 |
| 1750924858 | Linda Lavagnino | Marriage & Family Therapist | 17337 Ventura Blvd Ste 218, Encino, CA 91316-3994 | 2019-10-21 |
| 1912548439 | Tina Sammadi | Marriage & Family Therapist | 15611 Ventura Blvd, Encino, CA 91436-3128 | 2019-10-06 |
| 1437616356 | Candice Sherbin Mft, Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Ste 512, Encino, CA 91436-4720 | 2019-02-27 |
| 1215432638 | Morgan Taylor Rudnick | Marriage & Family Therapist | 16255 Ventura Blvd Ste 1212, Encino, CA 91436-2320 | 2018-03-27 |
| 1982112033 | Andrea Vicki Geffner | Marriage & Family Therapist | 16055 Ventura Blvd Ste 646, Encino, CA 91436-2632 | 2018-01-10 |
| 1932614310 | Hannah Esther Weinsrein | Marriage & Family Therapist | 17337 Ventura Blvd., Sutie #317, Encino, CA 91316 | 2017-12-07 |
| Find all providers in ENCINO | ||||
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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.