Joetta Deswarte Wallce, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

15928 Issued in CA

Practice address

2653 Elm Ave
Suite 200
Long Beach, CA 90806-1652

Phone

(562) 728-5000

Fax

(562) 595-5296

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1417258294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287900",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061652",
            "telephone_number": "562-728-5000",
            "fax_number": "562-595-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLCE",
        "first_name": "JOETTA",
        "middle_name": "DESWARTE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "244499",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "15928",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Sterling Wallace II, PSYD
• Melany A Wallace
• Michelle Wallace
• Natalie Wallace
• Venus Wallace
• Jeremy Wallender
• Karina M Waller
• Trayvone Waller, ACSW MSW
• Tama Walley, LCSW
• James Burton Wallis, MD

• Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.