Individual
ROBERT T WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, CNL, AMB-BC
Contact information
Practice address
1865 ELINORA DR, PLEASANT HILL, CA 94523-2810
(925) 293-2105
Mailing address
1865 ELINORA DR, PLEASANT HILL, CA 94523-2810
(925) 293-2105
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
95102138
CA
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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