STACIA MARIE WALLACE (NPI# 1750995452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750995452 |
| Entity Type | Individual |
| Full Name | STACIA MARIE WALLACE |
| Practice Address |
3800 Watt Ave Ste 110 Sacramento CA 95821-2622 |
| Practice Telephone | 9165847800 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942834163 | Stacia Wallace | Behavior Technician | 2500 Packard St, Ann Arbor, MI 48104-6827 | 2020-02-26 |
| Street Address |
3800 WATT AVE STE 110 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275960551 | Brittany Aimee Kelly | Counselor | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2013-10-02 |
| 1508476193 | Corey Lee Moore Jr. | Case Manager/Care Coordinator | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-08-07 |
| 1205453115 | Nicole Theresa Stiving | Social Worker | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-06-26 |
| 1649893298 | Rouchann Alicia Jackson | Counselor | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-05-18 |
| 1093353591 | Amanda Rodrigue-frasier | Student in an Organized Health Care Education/Training Program | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2019-12-15 |
| 1932627411 | Katherine Tidrick | Marriage & Family Therapist | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2017-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709458 | Andre Howard | Case Manager/Care Coordinator | 2281 Hurley Way Apt 10, Sacramento, CA 95825-2337 | 2020-10-26 |
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1891392676 | Natalie V Galaviz | Case Manager/Care Coordinator | 3815 Marconi Ave # 52, Sacramento, CA 95821-3867 | 2020-10-05 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1093332579 | David Lynch | Case Manager/Care Coordinator | 700 H St Ste 270, Sacramento, CA 95814-1289 | 2020-06-30 |
| 1770126906 | Chrysanthia D Leggett | Case Manager/Care Coordinator | 7415 Henrietta Dr Unit A, Sacramento, CA 95822-5142 | 2019-10-21 |
| 1558904870 | Larry Carter | Case Manager/Care Coordinator | 3700 Watt Ave Apt 13, Sacramento, CA 95821-2661 | 2019-10-18 |
| 1255982443 | Valerie Bishop | Case Manager/Care Coordinator | 5691 Boyton Way, Sacramento, CA 95823-3811 | 2019-09-27 |
| 1720637689 | Ayana Nuno | Case Manager/Care Coordinator | 1616 El Monte Ave, Sacramento, CA 95815-2903 | 2019-09-04 |
| 1154980597 | Nosazena Leo Uyigue | Case Manager/Care Coordinator | Sacramento County Mental Health Treatment Center, 2150 Stockton Boulevard, Sacramento, CA 95817-1337 | 2019-06-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
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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.