BRIAN WALLACE (NPI# 1861939845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861939845 |
| Entity Type | Individual |
| Full Name | BRIAN WALLACE |
| Credential | RADT 1 |
| Practice Address |
7907 Ostrow St Ste F San Diego CA 92111-3635 |
| Practice Telephone | 8583008282 |
| Mailing Telephone | 8583008282 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2018-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1235971116 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7545 Metropolitan Dr, San Diego, CA 921084402 | 6197189890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093866121 | Brian Wallace | Dentist | 781 S Lake Dr, Suite 1, Prestonsburg, KY 41653-1340 | 2007-01-16 |
| 1801864350 | Brian Wallace | Internal Medicine | 9005 Kilbride Rd, Baltimore, MD 21236-2017 | 2006-03-10 |
| 1831198811 | Brian David Wallace | Radiology | 1100 Brookhaven Rd, Franklin, KY 42134-2746 | 2005-07-20 |
| 1114378759 | Brian Charles Wallace | Physician Assistant | 125 W Catawba Ave, Mount Holly, NC 28120-1601 | 2016-06-24 |
| 1154677359 | Brian Venson Wallace | Physical Therapist | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2012-07-25 |
| 1598083495 | Brian William Wallace | Chiropractor | 139 Morristown Rd, Bernardsville, NJ 07924-2633 | 2010-05-17 |
| 1790017028 | Brian Edward Wallace | Anesthesiology | 400 E Pioneer Ave, Suite 101, Puyallup, WA 98372-3255 | 2010-02-11 |
| 1518118462 | Brian Robert Wallace | Orthopaedic Surgery | 1250 Pine Ridge Rd, Suite 203, Naples, FL 34108-8913 | 2008-10-08 |
| 1518124627 | Brian Scott Wallace | Emergency Medicine | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2008-05-18 |
| 1427248350 | Brian J Wallace | Physician Assistant | 325 Princeton Ave, Princeton, NJ 08540-1617 | 2007-07-26 |
| Street Address |
7907 OSTROW ST STE F |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92111-3635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811063860 | Pamela Dodgen | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2006-11-28 |
| 1720696966 | Esmeralda Siria | Student in an Organized Health Care Education/Training Program | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-07-14 |
| 1396369450 | Morgan Humberger | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-06-04 |
| 1619590296 | Jonas Carrera | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-05-18 |
| 1972122638 | Sabina Natalie Hernandez | Student in an Organized Health Care Education/Training Program | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-04-13 |
| 1013545334 | Letty Guadalupe Campa | Student in an Organized Health Care Education/Training Program | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-03-31 |
| 1114550464 | Renae Candice Williams | Case Manager/Care Coordinator | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2020-02-14 |
| 1780227041 | Rebecca Maria Iraheta | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2019-10-18 |
| 1679122949 | Melissa Renata Scott | Student in an Organized Health Care Education/Training Program | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2019-09-09 |
| 1215582689 | Carly Ann Graber | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2019-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
| 1912523804 | Access Medical, Inc. | Durable Medical Equipment & Medical Supplies | 4150 Convoy Street, Suite A, San Diego, CA 92111 | 2020-06-17 |
| 1154944551 | Mei Ling Milan Szeto | Student in an Organized Health Care Education/Training Program | 7917 Ostrow Street, Suite A, San Diego, CA 92111 | 2020-05-20 |
| 1346893831 | Leticia Isabel Peralta | Assistant Behavior Analyst | 563 Balboa Avenue. Number 521, San Diego, CA 92111 | 2019-07-23 |
| 1295204394 | Demetria Serfas | Behavioral Analyst | 563 Balboa Ave #521, San Diego, CA 92111 | 2018-11-19 |
| 1568981678 | Ross Psychology | Psychologist | 4883 Ronson Court, Suite K, San Diego, CA 92111 | 2017-09-11 |
| 1225554587 | Bianca Acosta | Technician, Other | 563 Balboa Ave. #521, San Diego, CA 92111 | 2017-08-18 |
| 1194240085 | Kazuhiro Kato | Dentist | 3707 Convoy St., San Diego, CA 92111 | 2017-08-11 |
| 1073038527 | Joanne Epps-yentz | Licensed Vocational Nurse | 7414 Mesa College Dr. Apt 47, San Diego, CA 92111 | 2017-08-06 |
| 1184158446 | Positive Behavior Supports Corp | Community/Behavioral Health | 563 Balboa Ave, 521, San Diego, CA 92111 | 2017-04-13 |
| Find all providers in zip 92111 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1477166734 | Laura Aida Andrade | Counselor | 4125 Wabash Ave, San Diego, CA 92104-2124 | 2020-08-26 |
| 1679113096 | David Salvador Avalos | Counselor | 3642 Rosa Linda St, San Diego, CA 92154-3653 | 2020-01-14 |
| 1023651692 | Robert Joseph Kassel | Counselor | 6551 Seaman St, San Diego, CA 92120-2629 | 2019-10-25 |
| 1609437979 | Pamela Lynette Hill | Counselor | 3960 W Point Loma Blvd, San Diego, CA 92110-5643 | 2019-06-26 |
| 1154989838 | Victoria Philips | Counselor | 4055 58th St Apt 10, San Diego, CA 92115-6209 | 2019-05-29 |
| 1740847375 | Jessica Cristina Williams | Counselor | 1775 Elm Ave, San Diego, CA 92154-1104 | 2019-05-20 |
| 1659934164 | Virginia Denise Mcswain | Counselor | 220 Euclid Ave Ste 200, San Diego, CA 92114-3644 | 2019-04-19 |
| 1386107324 | Connie Padera | Counselor | 3148 Midway Dr # 113, San Diego, CA 92110-4539 | 2019-04-08 |
| 1154891067 | Vincent Garside | Counselor | 2516 A Sreet, San Diego, CA 92102-9210 | 2018-12-04 |
| Find all providers in SAN DIEGO | ||||
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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.