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OLUFUNMI OSANEMOH WALLACE
NPI 1265321426
Licensed Vocational Nurse in Los Angeles, CA

Active since July 01, 2025
12029 AVALON BLVD, LOS ANGELES, CA 90061(323) 756-8191 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Olufunmi Osanemoh Wallace NPPES

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

OLUFUNMI OSANEMOH WALLACE (NPI 1265321426) is an individual licensed vocational nurse in Los Angeles, California, licensed in California (VN739159) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1265321426
Entity TypeIndividualFemale
Primary Taxonomy164X00000X
Provider Legal NameOLUFUNMI OSANEMOH WALLACE
Location Address12029 AVALON BLVDLos Angeles, CA 90061-2838
Mailing Address3565 Linden Ave Unit 249Long Beach, CA 90807-4529 · (951) 464-1263
Phone(323) 756-8191
Sole ProprietorNo
Enumeration DateJuly 1, 2025
NPPES CertifiedJuly 1, 2025
✔ NPI 1265321426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Vocational NurseNursing Service Providers
Taxonomy Code164X00000X
License✔ Licensed in CA · VN739159
Definition
A licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states.
12029 AVALON BLVD, Los Angeles, CA 90061
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Other Providers at the Same Location NPPES 3

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

AVALON VILLA HEALTH CARE LLC
Skilled Nursing Facility
12029 AVALON BLVD
LOS ANGELES, CA 90061
Los Angeles County (323) 756-8191
AKASH LOHIA DO
Physical Medicine & Rehabilitation
12029 AVALON BLVD
LOS ANGELES, CA 90061
Los Angeles County (872) 231-3162
AVALON POST ACUTE LLC
Skilled Nursing Facility
12029 AVALON BLVD
LOS ANGELES, CA 90061
Los Angeles County (323) 756-8191

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 Olufunmi Wallace's NPI number?

The NPI number for Olufunmi Wallace is 1265321426. It was assigned to this individual provider in the NPPES registry on July 1, 2025.

Where is Olufunmi Wallace located?

Olufunmi Wallace practices at 12029 Avalon Blvd, Los Angeles, CA 90061. The listed phone number is (323) 756-8191.

What is Olufunmi Wallace's specialty?

The primary specialty registered for this NPI is Licensed Vocational Nurse with taxonomy code 164X00000X.

When was this NPI record last updated?

The NPPES record for Olufunmi Wallace was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.