Wallace, Lisa

Wallace, Lisa is an individual health care provider with primary practice located at 10535 Hospital Way , Mather CA 95655-4200. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Wallace, Lisa can be contacted via phone (916) 366-5336.

Contact Information

Primary practice address
10535 Hospital Way Mather CA 95655-4200
Phone: (916) 366-5336
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 821591 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95006507 California

Profile Details

NPI number 1720476641
LBN Legal business name Wallace, Lisa
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2014
Last updated Nov 12th, 2021 - about 5 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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