Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JASON SCOTT WALLACE, PTA
ActiveMR. JASON SCOTT WALLACE, PTA is a Occupational Therapist healthcare provider located in CAMARILLO, California. NPI 1891786646 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · CAMARILLO, CA
Registration Details
- NPI Number
- 1891786646
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 1, 2005 (20.74221569495 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AT5146 (CA)
Practice Information
- Address
-
2486 N PONDEROSA DRSTE D-106CAMARILLO, CA, 930102376Browse CA providers · Browse ZIP 93010
- Phone
- 8054845447
- Primary Specialty
-
Occupational Therapist
225200000X
Other Occupational Therapist Providers in CAMARILLO, CA
| Name | Credential | NPI |
|---|---|---|
| JOSEPH TUPAS MARCELLA | PTA | 1194985184 |
| TERESA ELISENDA AAGAARD | P.T.A. | 1386924710 |
| MR. JEFFREY DON HORROCKS | PTA | 1730461922 |
| MRS. PAMELA ELIZABETH MIKITA | PTA | 1487904397 |
| JACLYN MICHELLE SALLE | — | 1164859674 |
| DALLAS MILLER | — | 1831642826 |
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.