STEPHANIE CELESTE WALLACE

VISTA, CA
NPI1518104942
Former NameSTEPHANIE CELESTE DEJARNETT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA19629)
Enumeration Date2009-01-07
Last Update Date2010-09-13
Business Address
STEPHANIE CELESTE WALLACE PA-C
1000 VALE TERRACE DR
VISTA, CA 92084-5218
Phone number: 760-631-5000
Mailing Address
STEPHANIE CELESTE WALLACE PA-C
1000 VALE TERRACE DR
VISTA, CA 92084-5218
Phone number: 760-631-5000
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