Yelda N Wallace

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY11975 Issued in FL

Practice address

3825 Henderson Blvd Ste 406
Tampa, FL 33629-5022

Phone

(813) 291-7150

Fax

(855) 318-5403

NPI assigned

May 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Yelda N Long Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Neuropsychology, LLCGroup PAC ID 7810142254, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bay Area Neuropsychology, LLC

  • Psychologist
  • Tampa, FL
  • NPI 1790023851
  Medicare reassignment Care Compare group
• Lecci Psychological Services, PLLC

  • Psychologist
  • Wilmington, NC
  • NPI 1811976426
  NPD

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1629651203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 NEVADA AVE NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337033344",
            "telephone_number": "703-981-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD STE 406",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295022",
            "telephone_number": "813-291-7150",
            "fax_number": "855-318-5403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 W Swann Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336094050",
            "country_code": "US",
            "telephone_number": "813-381-5200",
            "fax_number": "813-381-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "YELDA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY11975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YELDA",
            "last_name": "LONG",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debra Ann Wallace
• Peggy Lynn Wallace, ARNP
• Sergio Wallace
• Skye Wallace, M.S. CCC-SLP
• Tiaja Wallace
• Zandra Wynette Wallace
• Maria Wallen
• Marva Ann Marie Wallen, RN
• Seren Devol Wallen, PA-C
• Jennifer Lynn Waller, APRN

• Clinical Neuropsychologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.