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1902023070
JEFFEREY WALLACE
GILROY, CA
NPI
1902023070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2007-04-19
Last Update Date
2007-07-08
Business Address
-- JEFFEREY WALLACE
6980 CHESTNUT ST
GILROY, CA 95020-6635
Phone number: 408-842-7138
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Mailing Address
-- JEFFEREY WALLACE
125 BLAINE ST APT I
SANTA CRUZ, CA 95060-2894
Phone number:
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