Individual
TAWNI WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
5855 SILVER CREEK VALLEY RD, SAN JOSE, CA 95138-1059
(408) 574-9100
Mailing address
4500 THE WOODS DR APT 234, SAN JOSE, CA 95136-4634
(818) 439-8490
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
13548114-4101
UT
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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