Individual provider · Type 1 NPI

Jacob Wallace Ii

Mental Health Counselor · Oakland, CA

NPI number 1386809697 Active

Practice location

4368 Lincoln Ave
Oakland, CA 94602-2529

Call (510) 531-3111 Map

Fax (510) 530-8083

Mailing address

3419 69th Ave Apt 102
Oakland, CA 94605-2574

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1386809697

Jacob Wallace Ii's National Provider Identifier is 1386809697, issued on Jul 25, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oakland, CA. The record was last updated on Jul 25, 2008.