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Individual
MS. SONYA GOHEL WALLACE
Active
Individual
MS. SONYA GOHEL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18012
NP LICENSE
CA
01
—
672257
RN LICENSE
CA
01
—
F0208160
AANP CERTIFICATION
CA
Enumeration date
06/11/2008
Last updated
02/09/2009
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