Individual
SHANNON WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31835 EMERALD DR, WINCHESTER, CA 92596-9080
(210) 589-0046
Mailing address
31835 EMERALD DR, WINCHESTER, CA 92596-9080
(210) 589-0046
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
CA
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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