Demetre Wallace, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

300 Central Ave SW Ste 1500E
Albuquerque, NM 87102-3293

Phone

(505) 369-1731

Fax

(505) 218-9307

NPI assigned

Mar 23, 2026

Last updated

Mar 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Women in Leadership New Mexico Inc

  dba Women In Leadership

  • Cognitive & Behavioral Psychologist
  • Albuquerque, NM
  • NPI 1508633405
  NPD
• Women in Leadership New Mexico Inc

  dba Women In Leadership

  • Peer Specialist
  • Albuquerque, NM
  • NPI 1639947252
  NPD

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1639017445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CENTRAL AVE SW STE 1500E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023293",
            "telephone_number": "505-369-1731",
            "fax_number": "505-218-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTRAL AVE SW STE 1500E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023293",
            "telephone_number": "505-369-1731",
            "fax_number": "505-218-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DEMETRE",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsi V Walla, PA
• Jessica Erin Wallace Woodard, LPCC, CEAP
• Marci Ann Wallace-Innerhoffer, SLP
• Brenda Wallace, SLP
• Craig Wallace
• Janyce Wallace
• Jerron Wallace, LMSW
• Joshua Wallace, BS, MA
• Michael Alan Wallace, CNP
• Patricia Dianne Studerus Wallace, APRN

• Community Health Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community Health Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.