Individual provider · Type 1 NPI

Jason Scott Wallace, PTA

Physical Therapy Assistant · Camarillo, CA

NPI number 1891786646 Active

Practice location

2486 N Ponderosa Dr, Ste D-106
Camarillo, CA 93010-2376

Call (805) 484-5447 Map

Mailing address

4979 Burson Way
Oxnard, CA 93036-1017

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XAT5146 (CA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1891786646

Jason Scott Wallace, PTA's National Provider Identifier is 1891786646, issued on Nov 1, 2005. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Camarillo, CA. The record was last updated on Jul 13, 2026.