Individual
CATHERINE JESSICA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13130 BURBANK BLVD, SHERMAN OAKS, CA 91401-6037
(818) 731-0360
Mailing address
4001 STATE HWY 104, IONE, CA 95640
(209) 274-4911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34791
CA
Other
Enumeration date
08/14/2017
Last updated
08/13/2024
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