MRS. CONNIE J WALLACE (NPI# 1861588071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861588071 |
| Entity Type | Individual |
| Full Name | MRS. CONNIE J WALLACE |
| Credential | MFT |
| Practice Address |
1412 17th St # 352 Bakersfield CA 93301-5211 |
| Practice Telephone | 6612051522 |
| Practice Fax Number | 6618723247 |
| Mailing Telephone | 6612051522 |
| Mailing Fax Number | 6618723247 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-08-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
MFC40616 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851592711 | Connie S. Wallace | Speech-Language Pathologist | 10063 Irish Way, Union, KY 41091-7103 | 2007-05-29 |
| 1386668200 | Connie Lee Wallace | Counselor | 547 1/2 S James St, Ste. A, Dover, OH 44622-2137 | 2006-07-26 |
| 1619179132 | Connie Sue Wallace | Physician Assistant | 125 Baldwin Ave Ste 200, Charlotte, NC 28204-3370 | 2007-06-05 |
| 1821181603 | Connie L. Wallace | Counselor | 6435 E Broad St, Columbus, OH 43213-1507 | 2006-10-02 |
| Street Address |
1412 17TH ST # 352 |
| City | BAKERSFIELD |
| State | CA |
| Zip Code | 93301-5211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389528 | Tsoguik Broutian | Case Manager/Care Coordinator | Kern County Superintendent of Schools, 1300 17th St., Bakersfield, CA 93301 | 2020-09-08 |
| 1124665559 | Flourish Family Wellness Psychological Services, Inc. | Marriage & Family Therapist | 1909 16th Street, Suite 7, Bakersfield, CA 93301 | 2019-12-04 |
| 1063066231 | Alexandra Moo | Case Manager/Care Coordinator | 1415 Trutun Ave, Bakersfield, CA 93301 | 2019-07-26 |
| 1245898659 | Michael Dean Sampley | Marriage & Family Therapist | 2025 Westwind Dr. Ste. A, Bakersfield, CA 93301 | 2019-05-31 |
| 1740751619 | Jimmy Garcia | Counselor | Aegis Treatment Center, 1018 21st St, Bakersfield, CA 93301 | 2018-12-17 |
| 1689140741 | Prism Pain and Spine, Inc | Physical Medicine & Rehabilitation | 3838 San Dimas, Ste., 3838 San Dimas,ste. B-231, Bakersfield, CA 93301 | 2018-10-16 |
| 1215437678 | Andria Sousa | Behavior Technician | 2535 16th St Ste 215&210, Bakersfield, CA 93301 | 2018-02-12 |
| 1003329889 | County of Kern | Clinic/Center | 820 34th Street, Suite 100,201,202, 203, Bakersfield, CA 93301 | 2017-11-15 |
| 1306358577 | Ashley Marie Pereida | Case Manager/Care Coordinator | 3300 Truxtun Ave. Suite 200, Bakersfield, CA 93301 | 2017-10-28 |
| 1982123113 | Amber Freer Hayes | Licensed Vocational Nurse | 2001, 28th Street, Bakersfield, CA 93301 | 2017-09-19 |
| Find all providers in zip 93301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194239921 | Keneita Coane Rockhold | Counselor | 8707 Kayak Dr, Bakersfield, CA 93312-4911 | 2017-12-01 |
| 1659730919 | Genny Mutz | Counselor | 5114 Hartwick Ct, Bakersfield, CA 93313-2741 | 2016-02-15 |
| 1023432895 | Leah Louise Lopeteguy-hoffman | Counselor | 4949 Buckley Way Ste 112, Bakersfield, CA 93309-4881 | 2014-02-13 |
| 1992054092 | H. Norman Wright | Counselor | 12200 April Ann Ave, Bakersfield, CA 93312 | 2012-09-05 |
| 1588991202 | Rosie Stevens Witt | Counselor | 900 H St, Bakersfield, CA 93304-1312 | 2009-11-17 |
| 1538267943 | Gail Anne Lewis | Counselor | 8201 Camino Media Apt 103, Bakersfield, CA 93311-2014 | 2006-09-20 |
| 1174135024 | Keturah Hunte | Counselor | 3300 Truxtun Ave, Bakersfield, CA 93301-3137 | 2020-08-21 |
| 1710503206 | Jackie Holmes | Counselor | 9711 Holland St, Bakersfield, CA 93312-2772 | 2020-06-19 |
| 1790319184 | Luceli Salazar Osorio | Counselor | 2525 N Chester Ave, Bakersfield, CA 93308-1770 | 2020-02-25 |
| 1750947818 | Sheever Ollero | Counselor | 2000 Baker St, Bakersfield, CA 93305-3061 | 2019-05-14 |
| Find all providers in BAKERSFIELD | ||||
| City | BAKERSFIELD |
| Zip Code | 93301 |
Please comment or provide details below to improve the information on MRS. CONNIE J WALLACE.
| 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.