La Tanya Wallace
Community/Behavioral Health

Address: 3111 Camino Del Rio N Ste 4th, San Diego, CA 92108-5720
Phone: 6193987473

La Tanya Wallace (NPI# 1659978328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1659978328
Entity Type Organization
Organization Name LA TANYA WALLACE
Practice Address 3111 Camino Del Rio N Ste 4th
San Diego
CA 92108-5720
Practice Telephone 6193987473
Mailing Address 2608 University Ave
San Diego
CA 92104-2810
Mailing Telephone 6193987473
Authorized Official Name La Tanya Wallace (NURSE PRACTITIONER)
Authorized Official Telephone 6193987473
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2020-10-06
Last Update Date 2020-10-06

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 251J00000X Nursing Care Agencies
Yes 251S00000X Community/Behavioral Health Agencies

Other Provider/Organization Names

Other Name Type Code
La Tanya Wallace, NP Doing Business As Name - Organization

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790390359 Institute of Behavioral Sciences and Technology Family Counseling Community/Behavioral Health 9655 Granite Ridge Dr Ste Ofc2005, San Diego, CA 92123-2674 2020-09-10
1902426018 Clayton Counseling Licensed Clinical Social Worker Inc. Community/Behavioral Health 2180 Garnet Ave Ste 2e, San Diego, CA 92109-3675 2020-04-17
1679113765 Kristina Copley Marriage and Family Therapy, Inc Community/Behavioral Health 1267 Rosecrans St Ste B, San Diego, CA 92106-2692 2020-01-07
1417598319 Open Heart Leaders Community/Behavioral Health 1913 Euclid Ave Ste 108, San Diego, CA 92105-5360 2019-10-01
1710531405 Katherine Raftery Community/Behavioral Health 3570 Granada Ave, San Diego, CA 92104-4145 2019-07-31
1063064509 Abigail Frances Swan Community/Behavioral Health 3376 Grim Ave Apt 3, San Diego, CA 92104-4650 2019-07-15
1548726862 Unscripted Learning Community/Behavioral Health 3717 India St, San Diego, CA 92103-3727 2019-02-11
1356806509 Vista Hill Foundation Community/Behavioral Health 8825 Aero Drive, Suite 315, San Diego, CA 92123-1104 2019-02-01
1891275707 Kelley Kozlowski Community/Behavioral Health 4804 Iroquois Ave, San Diego, CA 92117-6248 2018-08-20
1780162594 Shirley Kim Community/Behavioral Health 10527 Caminito Pollo, San Diego, CA 92126-2816 2018-08-02
Find all providers in SAN DIEGO

Office Location

Street Address 3111 CAMINO DEL RIO N STE 4TH
City SAN DIEGO
State CA
Zip Code 92108-5720

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457963738 Diyana Giorgees Case Manager/Care Coordinator 5005 Texas Street, St. 203, San Diego, CA 92108 2020-08-19
1780211896 Lori Mildred Jerman Marriage & Family Therapist Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 2020-03-26
1285260737 Demetrius Anderson Counselor Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 2020-03-17
1033742465 Dasc Medical Inc Durable Medical Equipment & Medical Supplies 5520 Gill Village Way, 907, San Diego, CA 92108 2020-02-13
1508401092 Chanda Denee Kizer Marriage & Family Therapist 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 2019-11-08
1225695562 Jenna Rose Shurer Nurse Practitioner 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 2019-05-22
1952967812 Martha Kebede Mekonen Chiropractor 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 2019-05-16
1053886135 Andrea Jiselly Munoz Behavior Technician 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 2018-10-04
1386128916 Sarah Elisabeth Smith Counselor 7575 Metropolitan Dr., San Diego, CA 92108 2018-09-19
1902388358 Haleigh Mccue Boe Counselor 1660 Hotel Circle North Suite 320, San Diego, CA 92108 2018-09-02
Find all providers in zip 92108

Competitor

Search similar providers

City SAN DIEGO
Zip Code 92108

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Dataset Information

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.