Individual provider · Type 1 NPI

Patrick Wallace

Addiction (Substance Use Disorder) Counselor · San Diego, CA

NPI number 1376184408 Active

Practice location

4104 Delta St
San Diego, CA 92113-4113

Call (619) 264-0141 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1376184408

Patrick Wallace's National Provider Identifier is 1376184408, issued on Sep 30, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Diego, CA. The record was last updated on Sep 30, 2019.