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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. JESSICA ELIZABETH WALLACE, NURSE PRACTITIONER

Active

MS. JESSICA ELIZABETH WALLACE, NURSE PRACTITIONER is a Registered Nurse healthcare provider located in MANHATTAN BEACH, California. NPI 1215981170 is currently active in the NPPES registry. Verify at CMS.

Registered Nurse · MANHATTAN BEACH, CA

Registration Details

NPI Number
1215981170
Provider Type
Individual
Gender
Female
NPI Issued
May 22, 2006 (20.217391671663 yrs)
Last Updated
Dec 19, 2019
Licenses
547962 (CA)
10241 (CA)

Practice Information

Address
2200 N SEPULVEDA BLVD
MANHATTAN BEACH, CA, 902662910
Browse CA providers · Browse ZIP 90266
Phone
3108020200
Fax
3107949035
Primary Specialty
Registered Nurse
163W00000X
Additional Specialty
Family Nurse Practitioner

Other Registered Nurse Providers in MANHATTAN BEACH, CA

Name Credential NPI
JEFFREY MARCHESANI 1063873040
ANDREW LITAK 1376405621
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.