DR. JAMES DORAN WALLACE (NPI# 1013124908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013124908 |
| Entity Type | Individual |
| Full Name | DR. JAMES DORAN WALLACE |
| Credential | P.A.,D.C |
| Practice Address |
1650 Lead Hill Blvd Suite 600 Roseville CA 95661-3061 |
| Mailing Address |
8948 Salmon Falls Dr Sacramento CA 95826-1923 |
| Practice Telephone | 9167653785 |
| Practice Fax Number | 9163619869 |
| Mailing Telephone | 9167653785 |
| Mailing Fax Number | 9163619869 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2009-05-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NX0800X |
Chiropractor Specialization: Orthopedic |
12087 | CA | Chiropractic Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA14039 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226005 | James D Wallace | Technician | 67 Don Dale Dr, Foster, WV 25081 | 2020-08-20 |
| 1982173571 | James Preston Wallace II | Clinic/Center | 6234 Castlegate Dr W Apt 8112, Castle Rock, CO 80108-8655 | 2018-11-13 |
| 1356686877 | James Steven Wallace | Physical Therapy Assistant | 449 Main St Apt 131, Anderson, IN 46016-1186 | 2012-12-10 |
| 1033400999 | James Wallace | Durable Medical Equipment & Medical Supplies | 593 Bramlett Way, Powder Springs, GA 30127 | 2011-04-27 |
| 1841591559 | James Leeman Wallace | Massage Therapist | 29650 Sw Courtside Dr, #14, Wilsonville, OR 97070-7482 | 2010-11-11 |
| 1992023212 | James Joseph Wallace | Specialist | 154 Sugar Cane Dr, Hartwell, GA 30643-8120 | 2010-05-11 |
| 1538338413 | James Christopher Wallace | Military Health Care Provider | Uss Ross, Ddg 71, Fpo, AE 09586-1288 | 2008-02-26 |
| 1568664274 | James Christopher Wallace | Emergency Medical Technician, Basic | Cgc Chase (whec-718) Fpo Ap 96662-3932 32nd St, San Diego, CA 92106 | 2007-06-04 |
| 1760683924 | James G Wallace Jr. | Family Medicine | 525 Jay Ave, Brewster, WA 98812-3403 | 2007-05-29 |
| 1922143882 | James B Wallace Jr. | Dentist | 6618 Fm 2100, Crosby, TX 77532 | 2007-02-20 |
| Street Address |
1650 LEAD HILL BLVD SUITE 600 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-3061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811981277 | Scott Tyler Warren | Chiropractor | 1650 Lead Hill Blvd, # 600, Roseville, CA 95661-3061 | 2005-08-31 |
| 1831621291 | Vitality Frp Multidisciplinary Psychology and Physiotherapy for Chroni | Physical Therapist | 1650 Lead Hill Blvd, Roseville, CA 95661-3061 | 2017-04-03 |
| 1972856490 | Nalini G Prasad | Dermatology | 1650 Lead Hill Blvd, Suite 400, Roseville, CA 95661-3061 | 2012-10-22 |
| 1770853566 | Aubrey Tennant | Physical Therapist | 1650 Lead Hill Blvd, Roseville, CA 95661-3061 | 2012-01-10 |
| 1235438136 | Neil A Van Dyck, Dpm, Podiatry Corporation | Podiatrist | 1650 Lead Hill Blvd, # 100, Roseville, CA 95661-3061 | 2011-03-18 |
| 1144388331 | Kristin Wetter | Physical Therapist | 1650 Lead Hill Blvd, 300, Roseville, CA 95661-3061 | 2006-12-04 |
| 1851469845 | Sacramento Spine & Physical Therapy Inc. | Physical Therapist | 1650 Lead Hill Blvd, 300, Roseville, CA 95661-3061 | 2006-11-30 |
| 1205900065 | Bryan Robert Phillips | Physical Therapist | 1650 Lead Hill Blvd, 300, Roseville, CA 95661-3061 | 2006-11-20 |
| 1104990951 | Kevin Dumitru | Physical Therapist | 1650 Lead Hill Blvd, Suite 300, Roseville, CA 95661-3061 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497152763 | Joshua Lewis Cavaness | Physician Assistant | 2 Medical Plaza Dr Ste 255, Roseville, CA 95661-3050 | 2014-12-02 |
| 1619277712 | Anjali K Wilkerson | Physician Assistant | 576 N. Sunrise Ave, Ste. 220, Roseville, CA 95661 | 2010-10-24 |
| 1043305733 | Dorothy Ann Zamborsky | Physician Assistant | 851 Pleasant Grove Blvd Ste 110, Roseville, CA 95678-6176 | 2006-10-04 |
| 1285665620 | Julie Marie Gebhardt | Physician Assistant | 3001 Douglas Blvd Ste 325, Roseville, CA 95661-4289 | 2006-07-05 |
| 1396790358 | Shannon Rae Sgro | Physician Assistant | 1412 Blue Oaks Blvd, Roseville, CA 95747-7143 | 2006-05-24 |
| 1417595760 | William Murray | Physician Assistant | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2019-12-17 |
| 1366899437 | Chloe Ferrar | Physician Assistant | 1835 County Road C W, Roseville, MN 55113-1352 | 2016-05-18 |
| 1811354244 | Natalie Hope Pautsch | Physician Assistant | 2831 Snelling Ave N, Roseville, MN 55113-1712 | 2016-01-14 |
| 1609269927 | Abby Stretch | Physician Assistant | 4010 Foothills Blvd Ste 102, Roseville, CA 95747-7241 | 2015-03-11 |
| 1629460670 | Matthew Luther Case | Physician Assistant | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2015-02-27 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.