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Organization
LA TANYA WALLACE, NURSE PRACTITIONER & ASSOCIATES, INCORPORATED
Active
Organization
LA TANYA WALLACE, NURSE PRACTITIONER & ASSOCIATES, INCORPORATED
Active
Parent organization
LA TANYA WALLACE
Other names
La Tanya Wallace, NP
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA TANYA WALLACE
Authorized official
LA TANYA WALLACE NP (PRESIDENT)
(619) 398-7473
Entity
Organization
Contact information
Practice address
3356 2ND AVE STE G, SAN DIEGO, CA 92103-5636
(858) 717-0164
(888) 425-0508
Mailing address
6921 SPERRY CT, SAN DIEGO, CA 92111-7030
(619) 398-7473
(888) 425-0508
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
01/28/2024
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