Individual
SHAMIKA D WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, CWC
Contact information
Practice address
2852 PARKROW LN, SAN JOSE, CA 95132-3537
(408) 781-7680
Mailing address
2852 PARKROW LN, SAN JOSE, CA 95132-3537
(408) 781-7680
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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