Wallace, Jason Scott

Wallace, Jason Scott is an individual health care provider with primary practice located at 2486 N Ponderosa Dr Ste D-106, Camarillo CA 93010-2376. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Wallace, Jason Scott can be contacted via phone (805) 484-5447.

Contact Information

Primary practice address
2486 N Ponderosa Dr Ste D-106 Camarillo CA 93010-2376
Phone: (805) 484-5447
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X AT5146 California

Profile Details

NPI number 1891786646
LBN Legal business name Wallace, Jason Scott
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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