BRANDY RAE MARIE WALLACE (NPI# 1457833428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457833428 |
| Entity Type | Individual |
| Full Name | BRANDY RAE MARIE WALLACE |
| Practice Address |
56970 Yucca Trl Ste 104 Yucca Valley CA 92284-7911 |
| Mailing Address |
2010 Bullion Dr Twentynine Palms CA 92277-5017 |
| Practice Telephone | 7603690294 |
| Practice Fax Number | 7603690295 |
| Mailing Telephone | 2093807932 |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | AMFT108839 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093963035 | Brandy M Wallace | Counselor | 143 Rudy Ln, Rockingham, NC 28379-7694 | 2008-09-03 |
| 1770113441 | Brandy S Wallace | Nurse Practitioner | 6823 Saint Charles Ave Bldg 92, New Orleans, LA 70118-5665 | 2020-01-22 |
| 1497390389 | Brandy Dawn Wallace | Case Manager/Care Coordinator | 4455 E 12th Ave, Denver, CO 80220-2415 | 2019-11-14 |
| 1447370416 | Brandy Lynn Wallace | Occupational Therapy Assistant | 621 W 21st St, Andover, KS 67002-8498 | 2007-03-31 |
| Street Address |
56970 YUCCA TRL STE 104 |
| City | YUCCA VALLEY |
| State | CA |
| Zip Code | 92284-7911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780925719 | Sally Flores | Marriage & Family Therapist | 56970 Yucca Trl Ste 104, Yucca Valley, CA 92284-7911 | 2013-03-15 |
| 1770939225 | Valerie Traynham | Counselor | 56970 Yucca Trl Ste 104, Yucca Valley, CA 92284 | 2016-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821646746 | Dawn Irene Blue | Registered Nurse | 55887 Yucca Valley Trail, Yucca Valley, CA 92284 | 2019-09-04 |
| 1659838415 | Lifeline Marketing Group, LLC Kenneth M Folwell Sole Mbr | Genetic Counselor, MS | 57675 Twentynine Palms Hwy, Suite 102, Yucca Valley, CA 92284 | 2019-02-27 |
| 1790240026 | Rosenda Marie Quintero | Case Manager/Care Coordinator | 7281 Dumosa Avneue, Ste 4, Yucca Valley, CA 92284 | 2019-01-31 |
| 1740790617 | Robert Farrer | Pharmacist | 57701 Twentynine Palms Highway, Yucca Valley, CA 92284 | 2017-10-05 |
| 1881128981 | Louis James Medina | Case Manager/Care Coordinator | 58471 Twentynine Palms Hwy #102, Yucca Valley, CA 92284 | 2017-04-14 |
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1346639002 | Virginia Susan Mccann | Marriage & Family Therapist | 58945 Business Cernter Drive, Suite D, Yucca Valley, CA 92284 | 2015-01-20 |
| 1578964375 | Desert Oasis Healthcare | Clinic/Center | 57-840 29 Palms Hwy, Yucca Valley, CA 92284 | 2014-09-11 |
| 1306245113 | Katie Z Topper | Nurse Practitioner | 57402 Twentynine Palm Highway, Ste 1, Yucca Valley, CA 92284 | 2014-08-18 |
| 1215347307 | Sandip Patel | Pharmacist | 57701 Twentynine Palms Hwy, Yucca Valley, CA 92284 | 2014-04-29 |
| Find all providers in zip 92284 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023575040 | 3 To 8 Range Family Therapy, Inc. | Marriage & Family Therapist | 7211 Joshua Ln Ste 3, Yucca Valley, CA 92284-2956 | 2019-02-26 |
| 1194115162 | Integrated Therapeutic Services | Marriage & Family Therapist | 55379 29 Palms Hwy, Yucca Valley, CA 92284-2501 | 2015-01-29 |
| 1346639002 | Virginia Susan Mccann | Marriage & Family Therapist | 58945 Business Cernter Drive, Suite D, Yucca Valley, CA 92284 | 2015-01-20 |
| 1770915241 | Peter Martin Morris | Marriage & Family Therapist | 58975 Carmelita Cir, Yucca Valley, CA 92284-6433 | 2013-08-06 |
| 1780925719 | Sally Flores | Marriage & Family Therapist | 56970 Yucca Trl Ste 104, Yucca Valley, CA 92284-7911 | 2013-03-15 |
| 1235478496 | Brenda Jean Littleton | Marriage & Family Therapist | 58945 Business Center Dr Suite D, Yucca Valley, CA 92284-7307 | 2013-02-07 |
| 1558689877 | Laarni J Connelly | Marriage & Family Therapist | 58923 Business Center Dr. Ste E, Yucca Valley, CA 92284-3117 | 2010-05-11 |
| 1376688077 | Clement Miles Lucero | Marriage & Family Therapist | 58945 Business Center Dr. #d, Yucca Valley, CA 92284-7307 | 2007-02-20 |
| 1063551356 | Claire Louise Karp | Marriage & Family Therapist | 57718 Ivanhoe Dr, Yucca Valley, CA 92284-4428 | 2007-02-05 |
| 1427197680 | Deborah Ann Carter | Marriage & Family Therapist | 58967 Business Center Drive, Suite C/d, Yucca Valley, CA 92284 | 2007-02-05 |
| Find all providers in YUCCA VALLEY | ||||
| City | YUCCA VALLEY |
| Zip Code | 92284 |
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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.