Individual
MS. SHARMILA RAEVETTE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
5425 HOLLAND ST APT 3, OAKLAND, CA 94601-5742
(510) 533-3627
Mailing address
5425 HOLLAND ST APT 3, OAKLAND, CA 94601-5742
(510) 533-3627
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
—
—
Other
Enumeration date
11/21/2007
Last updated
11/21/2007
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