Individual provider · Type 1 NPI

Theresa Anne Wallace

Clinical Social Worker · Santa Ana, CA

NPI number 1619370798 Active

Practice location

1231 E Dyer Rd Ste 135
Santa Ana, CA 92705-5643

Call (949) 250-0488 Map

Fax (714) 540-1908

Mailing address

PO Box 12
Placentia, CA 92871-0012

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X94659 (CA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1619370798

Theresa Anne Wallace's National Provider Identifier is 1619370798, issued on Oct 2, 2014. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Santa Ana, CA. The record was last updated on Jan 13, 2022.