Jacob Wallace II

NPI 1386809697 - Counselor - 101YM0800X

NPI Details
NPI 1386809697
Gender Male
Enumeration Date 07/25/2008
Last Updated 07/25/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
OAKLAND CA, 94602-2529, US
Phone (510) 531-3111
Fax (510) 530-8083
Business Location
3419 69TH AVE APT 102
OAKLAND CA, 94605-2574, US
Phone (510) 569-2552
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Mr. Jacob Wallace II NPI is 1386809697, taxonomy code is 101YM0800X Jacob Wallace II physically located at 4368 Lincoln Ave, Oakland CA, 94602-2529. NPI Number Jacob Wallace II has the Individual type.

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1386809697 NPI number is provided on an as is basis without warranty of any kind. 1386809697 is maintained by the National Plan & Provider Enumeration System. The contents of Jacob Wallace II are for informational purposes only.