Individual
ANGELA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
21 METRO LN, SACRAMENTO, CA 95816-4396
(405) 210-0778
Mailing address
21 METRO LN, SACRAMENTO, CA 95816-4396
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95021029
CA
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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