Individual provider · Type 1 NPI

Deborah Wallace

Mental Health Counselor · West Sacramento, CA

NPI number 1194251173 Active

Practice location

3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467

Mailing address

801 Empire St
Fairfield, CA 94533-5702

Other practice locations

  • 801 Empire St, Fairfield, CA 94533 · (707) 425-5744

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1194251173

Deborah Wallace's National Provider Identifier is 1194251173, issued on May 11, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in West Sacramento, CA. The record was last updated on May 26, 2022.