Active NPI
La Tanya Wallace, Nurse Practitioner & Associates, Incorporated
Doing business as La Tanya Wallace, NP
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1659978328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- LA TANYA WALLACE, NURSE PRACTITIONER & ASSOCIATES, INCORPORATED
- Doing business as
- La Tanya Wallace, NP
- Practice address
- 3356 2ND Ave Ste G
San Diego, CA 92103-5636 - Phone
- (858) 717-0164
- Fax
- (888) 425-0508
- NPI assigned
- Oct 6, 2020
- Last updated
- Jan 28, 2024
- Organization subpart
- Yes
- Parent organization
- LA TANYA WALLACE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- La Tanya Wallace, NP
- Title
- President
- Phone
- (619) 398-7473
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
3356 2ND Ave Ste G
San Diego, CA 92103-5636
Mailing address
6921 Sperry CT
San Diego, CA 92111-7030
Phone (619) 398-7473
Other names 1
- La Tanya Wallace, NP
National Provider Directory
National Provider Directory- Part of
- La Tanya Wallace
Locations
3111 Camino del Rio N
Ste 4TH
San Diego, CA 92108
3356 2nd Ave
Ste G
San Diego, CA 92103
Phone (619) 398-7473
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- San Diego, CA
- NPI 1841453487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601942400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706400000000",
"number": "1659978328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6921 SPERRY CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921117030",
"telephone_number": "619-398-7473",
"fax_number": "888-425-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3356 2ND AVE STE G",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921035636",
"telephone_number": "858-717-0164",
"fax_number": "888-425-0508"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LA TANYA WALLACE, NURSE PRACTITIONER & ASSOCIATES, INCORPORATED",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LA TANYA WALLACE",
"enumeration_date": "2020-10-06",
"last_updated": "2024-01-28",
"certification_date": "2024-01-28",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "LA TANYA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "619-398-7473",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "La Tanya Wallace, NP",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "La Tanya Wallace, NP",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Diego, CA
- La Mesa Elder Care, LLC (La Mesa Elder Care)
- Autumn La Pierre
- Christopher N La Rosa, PT
- Cheryl La Sasso, PSY.D.
- Regina Marie La Scala
- Patrick La Vallo, MD
- David Benjamin Tevis La Vine, M.D.
- La Vita Compounding Pharmacy LLC (La Vita Compounding Pharmacy)
- Michael Stephen La Voy, LMFT
- Tina Marie La Voy, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.