1. Home
  2. Directory
  3. California
  4. Antioch
  5. Speech Language Pathologist
  6. NPI Profile

JANE OLIVER WALLIS M.S-SLP
NPI 1255685590
Speech-Language Pathologist in Antioch, CA

Active since November 08, 2012
4501 SAND CREEK RD, ANTIOCH, CA 94531(925) 813-6420 Get Directions Write a Review

NPPES record last updated: January 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 13, 2022, Jul 13, 2021, Jan 9, 2018 (3 updates tracked since 2018).

About Jane Oliver Wallis M.s-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JANE OLIVER WALLIS M.S-SLP (NPI 1255685590) is an individual speech-language pathologist provider in Antioch, California, licensed in California (7414) and active in the NPI registry since November 2012.

NPPES Registry Identity

NPI1255685590
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameJANE OLIVER WALLISCredential: M.S-SLP
Location Address4501 SAND CREEK RDAntioch, CA 94531-8687
Mailing Address4501 Sand Creek RdAntioch, CA 94531-8687 · (925) 813-7706
Phone(925) 813-6420
Sole ProprietorYes
Enumeration DateNovember 8, 2012
Last NPPES UpdateJanuary 13, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2022
✔ NPI 1255685590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in CA · 7414
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
4501 SAND CREEK RD, Antioch, CA 94531
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jane Oliver Wallis M.s-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jane Wallis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
27 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTEN ASAKO SHIMODA PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-7280
DR. KAUSALYA CHENNAPRAGADA BHASKARABHATLA M.D.
Internal Medicine
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6500
JEFFREY ROBERT CHAVEZ PA-C
Physician Assistant
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 389-7719
DR. JAMES FRANCIS CHAN M.D.
Hospitalist
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6500
JACOB FREDRICKSON DPT
Physical Therapist
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6500
MENG HAO
Pharmacist
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6500
TIMOTHY VAN PHAN
Pharmacist
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6500
SHARON ANN LEWIS RRT
Respiratory Therapist, Registered
4501 SAND CREEK RD
ANTIOCH, CA 94531
Contra Costa County (925) 813-6700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jane Wallis's NPI number?

The NPI number for Jane Wallis is 1255685590. It was assigned to this individual provider in the NPPES registry on November 8, 2012.

Where is Jane Wallis located?

Jane Wallis practices at 4501 Sand Creek Rd, Antioch, CA 94531. The listed phone number is (925) 813-6420.

What is Jane Wallis's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jane Wallis enrolled in Medicare?

Yes. Jane Wallis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jane Wallis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jane Wallis reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jane Wallis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jane Wallis was last updated on January 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.