Amy E Wallace (NPI# 1144231499, PAC ID# 3678672599) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1144231499 |
| PAC ID by PECOS | 3678672599 |
| Professional Enrollment ID | I20161104001317 |
| Full Name | Amy E Wallace |
| Organization Legal Name | ADVENTIST HEALTH ST. HELENA OB/GYN |
| Address |
15322 Lakeshore Dr Suite 102 Clearlake CA 95422-9815 |
| Phone Number | 7079950193 |
| Gender | F |
| Medical School | UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON |
| Graduation Year | 1987 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 9234038209 |
| Number of Group Practice Members | 32 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050013 | ST HELENA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 | 7079950193 | ADVENTIST HEALTH ST. HELENA OB/GYN |
| 15322 Lakeshore Dr, Clearlake, CA 95422-9815 | 7079950193 | ADVENTIST HEALTH ST. HELENA OB/GYN |
| 1425 W Main St, Walnut Ridge, AR 72476-1431 | 8708865303 | FAMILIES, INC OF ARKANSAS |
| Organization Legal Name | ADVENTIST HEALTH ST. HELENA OB/GYN |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert P Albanese Jr. | Psychiatry | Adventist Health St. Helena Ob/gyn | 10 Woodland Rd, Suite 502, St Helena, CA 94574-9554 |
| Cynthia A Janes | Psychiatry | Adventist Health St. Helena Ob/gyn | 10 Woodland Rd, Suite 502, St Helena, CA 94574-9554 |
| Peggy Boyar Thomas | Nurse Practitioner | Adventist Health St. Helena Ob/gyn | 999 Adams St, Suite 106, Saint Helena, CA 94574-1168 |
| Srikanth Prayaga | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Susan R Gamble | Internal Medicine | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Timothy I Lawver | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Joachim D Raese | Psychiatry | Adventist Health St. Helena Ob/gyn | 10 Woodland Rd, Suite 502, St Helena, CA 94574-9554 |
| Samee S Shahzada | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Heather M Lewerenz | Psychiatry | Adventist Health St. Helena Ob/gyn | 10 Woodland Rd, Suite 502, St Helena, CA 94574-9554 |
| Angela Burt | Psychiatry | Adventist Health St. Helena Ob/gyn | 10 Woodland Rd, Suite 502, St Helena, CA 94574-9554 |
| Street Address |
15322 LAKESHORE DR SUITE 102 |
| City | CLEARLAKE |
| State | CA |
| Zip | 95422-9815 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael T Young | Pain Management | Adventist Health Physicians Network | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Kristin M Groessl | Physician Assistant | Adventist Health Physicians Network | 15322 Lakeshore Dr, Clearlake, CA 95422-9815 |
| Norma Medina | Nurse Practitioner | Adventist Health Physicians Network | 15322 Lakeshore Dr, Clearlake, CA 95422-9815 |
| Jon S Portnoff | Cardiovascular Disease (cardiology) | Adventist Health Physicians Network | 15322 Lakeshore Dr, Clearlake, CA 95422-9815 |
| Ethan D Schram | Hematology/oncology | Adventist Health Physicians Network | 15322 Lakeshore Dr, Clearlake, CA 95422-9815 |
| Gary W Andrus | Qualified Audiologist | Adventist Health Physicians Network | 15322 Lakeshore Dr, Clearlake, CA 95422-9815 |
| Srikanth Prayaga | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Susan R Gamble | Internal Medicine | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Timothy I Lawver | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Samee S Shahzada | Psychiatry | Adventist Health St. Helena Ob/gyn | 15322 Lakeshore Dr, Suite 102, Clearlake, CA 95422-9815 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric E Kim | Internal Medicine | 4456 Manzanita Ave, C, Clearlake, CA 95422-7937 | |
| Raymond D Jennings | Internal Medicine | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Martin Paukert | Plastic and Reconstructive Surgery | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Christopher P Lombardo | Otolaryngology | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Michael Rudolph Cosenza | Podiatry | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Andrew B Chung | Ophthalmology | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Ian D Macagy | Obstetrics/gynecology | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Jenny L Senff | Nurse Practitioner | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Kimberly Fordham | Family Practice | Adventist Health Physicians Network | 15230 Lakeshore Dr, Clearlake, CA 95422-8107 |
| Joanne Rode | Physician Assistant | 7000 B S Ctr Dr, Unit A, Clearlake, CA 95422-8131 | |
| Find all physicians in zip 95422 | |||
| City | CLEARLAKE |
| Zip Code | 95422 |
| Specialty | PSYCHIATRY |
| City + Specialty | CLEARLAKE + PSYCHIATRY |
Please comment or provide details below to improve the information on Amy E Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.