Individual
CAITLIN ELIZABETH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 FRUITVALE AVE, OAKLAND, CA 94601-2927
(510) 300-3170
Mailing address
1315 FRUITVALE AVE, OAKLAND, CA 94601-2927
(510) 300-3170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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