Jesse Wallace
NPI #1174005995 in Chatsworth, California
Provider Information
- NPI Number
- 1174005995
- Entity Type
- Individual
- Name
- Jesse Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Aug 29, 2018
- Last Updated
- Aug 29, 2018
Practice Location
- Address
- 21000 PLUMMER ST
- City
- Chatsworth
- State
- California
- ZIP Code
- 91311-4903
- Phone
- (818) 882-6400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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