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Alycia Grace Wallace
Peer Specialist in Orange, California
NPI 1255975801

Alycia Grace Wallace is a Peer Specialist based in Orange, CA. Alycia Grace Wallace practices in Orange, CA. The NPI Number for Alycia Grace Wallace is 1255975801 and holds a License No. (California).

The current practice location address for Alycia Grace Wallace is 401 S Tustin St Bldg C, Orange, CA and can be reached out via phone at 714-361-4860 and via fax at 714-361-4861.

Location: 401 S Tustin St Bldg C, Orange, CA, 92866-2550
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255975801
Provider Name
Alycia Grace Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
401 S Tustin St Bldg C, Orange, CA, 92866-2550
Phone Number
714-361-4860
Fax Number
714-361-4861
Provider Enumeration Date
11/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
401 S Tustin St Bldg C
City
Orange
State
California
Zip
92866-2550
Phone Number
714-361-4860
Fax Number
714-361-4861
person
Provider Business Mailing Address Details
Address
401 S Tustin St Bldg C
City
Orange
State
California
Zip
92866-2550
Phone Number
714-361-4860
Fax Number
714-361-4861
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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