Individual provider · Type 1 NPI

Katherine Renee Wallace

Mental Health Counselor · Stockton, CA

NPI number 1750013330 Active

Practice location

1212 N California St
Stockton, CA 95202-1552

Call (209) 468-0103 Map

Mailing address

135 W Wyandotte St
Stockton, CA 95204-5324

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1750013330

Katherine Renee Wallace's National Provider Identifier is 1750013330, issued on Jun 30, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Stockton, CA. The record was last updated on Jun 30, 2022.