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1386809697
JACOB WALLACE
OAKLAND, CA
NPI
1386809697
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-07-25
Last Update Date
2008-07-25
Business Address
Mr. JACOB WALLACE
4368 LINCOLN AVE
OAKLAND, CA 94602-2529
Phone number: 510-531-3111
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Mailing Address
Mr. JACOB WALLACE
3419 69TH AVE APT 102
OAKLAND, CA 94605-2574
Phone number: 510-569-2552
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