DE VORIA WALLACE (NPI# 1144777483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144777483 |
| Entity Type | Individual |
| Full Name | DE VORIA WALLACE |
| Practice Address |
425 S Broadway Los Angeles CA 90013-1102 |
| Mailing Address |
6666 Green Valley Cir Culver City CA 90230-7068 |
| Practice Telephone | 2132130100 |
| Practice Fax Number | 2132130108 |
| Mailing Telephone | 3103058878 |
| Mailing Fax Number | 3108465278 |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2016-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
425 S BROADWAY |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90013-1102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295967693 | Emotional Health Association | Community/Behavioral Health | 425 S Broadway, Los Angeles, CA 90013-1102 | 2009-08-18 |
| 1790306983 | Joseline Martinez | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2020-04-29 |
| 1265067359 | Jose Gutierrez Ortega | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2020-03-09 |
| 1659911410 | Jerry Abby Loeb | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2020-01-09 |
| 1598327454 | Mariela Escobar | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2019-07-01 |
| 1588151161 | David Matthew Brena | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2018-04-18 |
| 1760935324 | Emily Wu Truong | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2016-08-01 |
| 1184001679 | Hubert Price | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2015-05-04 |
| 1821498593 | James Christopher | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2014-08-29 |
| 1780024182 | Jennifer Rose Stautzenberger | Case Manager/Care Coordinator | 425 S Broadway, Los Angeles, CA 90013-1102 | 2013-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013470327 | Mia Rashap | Technician, Other | 555 W 5th St, Los Angeles, CA 90013 | 2019-04-12 |
| 1992263941 | Shiane Lyana Ferretti | Technician, Other | 555 West 5th Street, Los Angeles, CA 90013 | 2019-03-08 |
| 1629567060 | Dtla Med | Clinic/Center | 431 S Hewitt St Ste B, Los Angeles, CA 90013 | 2018-05-01 |
| 1386150886 | Abel Joseph Apodaca Jr. | Counselor | 512 East 4th Street, Los Angeles, CA 90013 | 2017-12-19 |
| 1578075560 | Anthony Perez | Case Manager/Care Coordinator | 522 S San Pedro, Los Angeles, CA 90013 | 2017-10-30 |
| 1740724574 | Royalty Group Services Inc | Clinic/Center | 555 West Fifth Street 31st Floor, Los Angeles, CA 90013 | 2016-12-13 |
| 1275930877 | Araceli Zuniga | Rehabilitation Practitioner | 640 South Maple Avenue, Los Angeles, CA 90013 | 2014-11-25 |
| 1558785956 | Carlos Mejia | Counselor | 470 E. 3rd St., Los Angeles, CA 90013 | 2014-02-06 |
| 1679908081 | Troy Gabrielson | Counselor | 470 E. 3rd Street, Suite C, Los Angeles, CA 90013 | 2013-09-05 |
| 1417298753 | Pierre Houbein | Physician Assistant | 311 Winston St., Los Angeles, CA 90013 | 2013-03-12 |
| Find all providers in zip 90013 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1245855725 | Ashley Ivette Berumen | Case Manager/Care Coordinator | 1900 W Slauson Ave, Los Angeles, CA 90047-1129 | 2020-06-10 |
| 1356965776 | Jennifer Yanovski | Case Manager/Care Coordinator | 316 W 2nd St Ste 202, Los Angeles, CA 90012-3527 | 2020-06-01 |
| 1841820560 | Kiara Imani Thomas | Case Manager/Care Coordinator | 226 E 103rd St, Los Angeles, CA 90003-4720 | 2020-01-22 |
| 1023648748 | Christopher Rivas | Case Manager/Care Coordinator | 1410 N Kenmore Ave Apt 5, Los Angeles, CA 90027-5826 | 2020-01-22 |
| 1396383782 | Candace Laolagi | Case Manager/Care Coordinator | 246 E 47th St, Los Angeles, CA 90011-3908 | 2019-12-16 |
| 1902448343 | Aster Libasu | Case Manager/Care Coordinator | 2619 Wilshire Blvd Apt 1005, Los Angeles, CA 90057-3461 | 2019-10-16 |
| 1831749456 | Jasmine Lynn Martinez | Case Manager/Care Coordinator | 6768 Lexington Ave, Los Angeles, CA 90038-1234 | 2019-09-16 |
| 1033762547 | John Charles Gutierrez | Case Manager/Care Coordinator | 4265 S Normandie Ave, Los Angeles, CA 90037-2324 | 2019-07-23 |
| 1609429976 | Vianey Colon | Case Manager/Care Coordinator | 11601 S Western Ave # O, Los Angeles, CA 90047-5006 | 2019-07-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90013 |
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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.