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Mr. Jacob Wallace II
Mental Health Counselor in Oakland, California
NPI 1386809697

Jacob Wallace II is a Mental Health Counselor based in Oakland, CA and is specialized in Mental Health. Jacob Wallace II practices in Oakland, CA. The NPI Number for Jacob Wallace II is 1386809697 and holds a License No. (California).

The current practice location address for Jacob Wallace II is 4368 Lincoln Ave, Oakland, CA and can be reached out via phone at 510-531-3111 and via fax at 510-530-8083.

Location: 4368 Lincoln Ave, Oakland, CA, 94605-2574
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386809697
Provider Name
Jacob Wallace II
Credential
Provider Entity Type
Individual
Gender
Male
Address
4368 Lincoln Ave, Oakland, CA, 94605-2574
Phone Number
510-531-3111
Fax Number
510-530-8083
Provider Enumeration Date
07/25/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4368 Lincoln Ave
City
Oakland
State
California
Zip
94602-2529
Phone Number
510-531-3111
Fax Number
510-530-8083
person
Provider Business Mailing Address Details
Address
4368 Lincoln Ave
City
Oakland
State
California
Zip
94602-2529
Phone Number
510-531-3111
Fax Number
510-530-8083
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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