Search › California › 374J00000X
Dina Wallace
NPI 1477444628 · on the registry since 2025 · sole proprietor
Practice
- Address
- 25354 Sequoiawood Way
Lake Forest, CA 92630 - Phone
- (714) 797-1604
Registry record
- Primary taxonomy
- 374J00000X
374J00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-07-14
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