Individual provider · Type 1 NPI
Jamie P. Wallace, SUD COUNSELOR
Addiction (Substance Use Disorder) Counselor · Vallejo, CA
NPI number
1972447209
Active
Practice location
1628 Broadway St
Vallejo, CA 94590-2405
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | R1541450124 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
14 other providers at this address
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About NPI 1972447209
Jamie P. Wallace, SUD COUNSELOR's National Provider Identifier is 1972447209, issued on Apr 16, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vallejo, CA. The record was last updated on Apr 16, 2026.