Aminah Wallace, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95032514 Issued in CA

Practice address

2648 Carson Way
Antioch, CA 94531-8270

Phone

(619) 534-5998

NPI assigned

Jul 21, 2025

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbor Wound Care P CGroup PAC ID 0042704504, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Harbor Wound Care P.C.

  • General Practice Physician
  • Banning, CA
  • NPI 1427922392
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1790677912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 CARSON WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318270",
            "telephone_number": "619-534-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 CARSON WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318270",
            "telephone_number": "619-534-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "AMINAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95032514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deseray Marie Walker-Perry
• Josephine Walker
• Malikea Walker, LCSW
• Synitha Renae Walker
• Tara Walker
• Jodie Elizabeth Wallace, RD
• Jane Oliver Wallis, M.S-SLP
• Walmart Inc. (Walmart Pharmacy 10-2697)
• Walmart, Inc. (Walmart pharmacy 10-3164)
• Alexander T Wang, MD

• Acute Care Nurse Practitioner in Antioch, CA
• Providers in Antioch, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.