Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JORDAN CORNELL WALLACE
Active Sole ProprietorJORDAN CORNELL WALLACE is a Behavior Technician healthcare provider located in CATHEDRAL CITY, California. NPI 1689449787 is currently active in the NPPES registry. Verify at CMS.
Behavior Technician · CATHEDRAL CITY, CA
Registration Details
- NPI Number
- 1689449787
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 17, 2023 (2.7452403693778 yrs)
- Last Updated
- Nov 17, 2023
- Sole Proprietor
- Yes
Practice Information
- Address
-
69155 DINAH SHORE DRCATHEDRAL CITY, CA, 922344792Browse CA providers · Browse ZIP 92234
- Phone
- 7609699383
- Primary Specialty
-
Behavior Technician
106S00000X
Other Behavior Technician Providers in CATHEDRAL CITY, CA
| Name | Credential | NPI |
|---|---|---|
| ANGEL IKA PEREZ | — | 1669934535 |
| CRYSTINA ROSE JUSTICE | — | 1679141410 |
| NANCY DEL CASTILLO | — | 1164091401 |
| MISS ESMERALDA LEON | SOME COLLEGE | 1265191167 |
| APRILLE ANDREA GARCIA AGRIAM | — | 1376226688 |
| BELEN MONTOYA | — | 1063242733 |
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.