Search › California › 163W00000X
Jessica Wallace, NURSE PRACTITIONER
NPI 1215981170 · on the registry since 2006
Practice
- Address
- 2200 N Sepulveda Blvd
Manhattan Beach, CA 90266 - Phone
- (310) 802-0200
- Fax
- (310) 794-9035
- Clinicians at this address
- 3
Additional practice sites
- 1245 16th St Ste 110, Santa Monica, CA
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Also registered as
- 363LF0000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-12-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California