Individual provider · Type 1 NPI
Aminah Wallace, NP
Acute Care Nurse Practitioner · Antioch, CA
NPI number
1790677912
Active
Practice location
2648 Carson Way
Antioch, CA 94531-8270
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 95032514 (CA) |
Acute Care Nurse Practitioner: Definition to come...
About NPI 1790677912
Aminah Wallace, NP's National Provider Identifier is 1790677912, issued on Jul 21, 2025. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Antioch, CA. The record was last updated on Jul 21, 2025.