Waller, Austin Tanaka

Waller, Austin Tanaka is an individual health care provider with primary practice located at 995 Gateway Center Way Ste 300 , San Diego CA 92102-4550. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst, Other Service Providers / Case Manager/Care Coordinator, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor is his primary health care specialty. Waller, Austin Tanaka can be contacted via phone (619) 398-2168.

Contact Information

Primary practice address
995 Gateway Center Way Ste 300 San Diego CA 92102-4550
Phone: (619) 398-2168
Fax: (619) 398-2168
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X F5130372 California
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X California

Profile Details

NPI number 1508350851
LBN Legal business name Waller, Austin Tanaka
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2018
Last updated Mar 27th, 2025 - about last year

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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