Christina Wallace

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

41160 Issued in CA

Practice address

579 Via del Caballo
San Marcos, CA 92078-8911

Phone

(503) 883-1686

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Mobile Therapy a Professional Physical Therapy CorpGroup PAC ID 0648401349, 9 clinicians

Home Physical Therapy Providers and Wellness IncGroup PAC ID 4789989955, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Coastal Mobile Therapy a Professional Physical Therapy Corp

  • Physical Therapist
  • Oceanside, CA
  • NPI 1962843078
  Medicare reassignment Care Compare group NPD
• Home Physical Therapy Providers & Wellness Inc.

  • Physical Therapist
  • Escondido, CA
  • NPI 1073999264
  Medicare reassignment Care Compare group NPD
• Daniel Norman Sheehy, P.T.

  • Geriatric Physical Therapist
  • Escondido, CA
  • NPI 1063837185
  Medicare reassignment

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1861811671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 VIA DEL CABALLO",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920788911",
            "telephone_number": "503-883-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 VIA DEL CABALLO",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920788911",
            "telephone_number": "503-883-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brynn Babette Waddington, PA-C
• Judy Wahl Talley, M.A., L.M.F.T.
• Alexandra Nicole Walker, DNP, APRN, FNP-C
• Calista Walker
• Arden Wallace
• Walmart Inc. (Walmart Pharmacy 10-3494)
• Walmart Stores, Inc. (Vision Center 30-3494)
• Kirra Walsh, AMFT
• Kristin Walsh
• Tina Wan

• Physical Therapist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.