LA TANYA WALLACE

SAN DIEGO, CA
NPI1841453487
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  22485)
Additional Taxonomies163W00000X Registered Nurse
(Licence: CA  680663)
363L00000X Nurse Practitioner
(Licence: CA  22485)
363LF0000X Nurse Practitioner, Family
(Licence: CA  680663)
363LF0000X Nurse Practitioner, Family
(Licence: CA  22485)
Enumeration Date2008-07-03
Last Update Date2024-01-28
Business Address
LA TANYA WALLACE FNP
6921 SPERRY CT
SAN DIEGO, CA 92111-7030
Phone number: 858-717-0164
Mailing Address
LA TANYA WALLACE FNP
6921 SPERRY CT
SAN DIEGO, CA 92111-7030
Phone number: 858-717-0164