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

MR. SYLVESTER LEE WALLACE JR.

Active

MR. SYLVESTER LEE WALLACE JR. is a Community Health Worker healthcare provider located in GRAND TERRACE, California. NPI 1427827625 is currently active in the NPPES registry. Verify at CMS.

Community Health Worker · GRAND TERRACE, CA

Registration Details

NPI Number
1427827625
Provider Type
Individual
Gender
Male
NPI Issued
Dec 28, 2023 (2.6117358943519 yrs)
Last Updated
Feb 22, 2024
License
NONE

Practice Information

Address
21935 VAN BUREN ST STE A1
GRAND TERRACE, CA, 923135652
Browse CA providers · Browse ZIP 92313
Phone
9099061023
Fax
9099061032
Primary Specialty
Community Health Worker
172V00000X
Additional Specialty
Community Health Worker

Other Community Health Worker Providers in GRAND TERRACE, CA

Name Credential NPI
MARY CARRILLO 1477925790
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.