Individual
AMINAH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2648 CARSON WAY, ANTIOCH, CA 94531-8270
(619) 534-5998
Mailing address
2648 CARSON WAY, ANTIOCH, CA 94531-8270
(619) 534-5998
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95032514
CA
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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