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Katherine Renee Wallace
Mental Health Counselor in Stockton, California
NPI 1750013330

Katherine Renee Wallace is a Mental Health Counselor based in Stockton, CA and is specialized in Mental Health. Katherine Renee Wallace practices in Stockton, CA. The NPI Number for Katherine Renee Wallace is 1750013330 and holds a License No. (California).

The current practice location address for Katherine Renee Wallace is 1212 N California St, Stockton, CA and can be reached out via phone at 209-468-0103.

Location: 1212 N California St, Stockton, CA, 95204-5324
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750013330
Provider Name
Katherine Renee Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
1212 N California St, Stockton, CA, 95204-5324
Phone Number
209-468-0103
Fax Number
Provider Enumeration Date
06/30/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1212 N California St
City
Stockton
State
California
Zip
95202-1552
Phone Number
209-468-0103
Fax Number
person
Provider Business Mailing Address Details
Address
1212 N California St
City
Stockton
State
California
Zip
95202-1552
Phone Number
209-468-0103
Fax Number
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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