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JENNIFER WALLACE SUDRC
NPI 1508532953
Counselor - Addiction (Substance Use Disorder) in Santa Rosa, CA

Active since August 17, 2021
98 HENDLEY ST, SANTA ROSA, CA 95404(707) 527-0412 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 9, 2024, Aug 26, 2021, Aug 17, 2021 (3 updates tracked since 2021).

About Jennifer Wallace Sudrc NPPES

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

JENNIFER WALLACE SUDRC (NPI 1508532953) is an individual addiction (substance use disorder) provider in Santa Rosa, California, licensed in California (R1441130821) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1508532953
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJENNIFER WALLACECredential: SUDRC
Location Address98 HENDLEY STSanta Rosa, CA 95404-5025
Mailing AddressPo Box 1356Santa Rosa, CA 95402-1356 · (707) 527-0412
Phone(707) 527-0412
Sole ProprietorNo
Enumeration DateAugust 17, 2021
Last NPPES UpdateJuly 9, 20243 updates tracked since enumeration
NPPES CertifiedJuly 9, 2024
✔ NPI 1508532953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1441130821
98 HENDLEY ST, Santa Rosa, CA 95404
Open in Google Maps ↗

Other Providers at the Same Location NPPES 16

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

WOMEN'S RECOVERY SERVICES, A UNIQUE PLACE
Substance Abuse Rehabilitation Facility
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
MARIE ANTIONETTE JEFFERSON
Counselor (Addiction (Substance Use Disorder))
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0712
WOMEN'S RECOVERY SERVICES
Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children)
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
WOMEN'S RECOVERY SERVICES
Substance Abuse Rehabilitation Facility
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
KATHRYN JOANNE PRESSON
Counselor (Addiction (Substance Use Disorder))
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
TERESA KRISTINA REA
Case Manager/Care Coordinator
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
SARA MARIE GONZALES SUDCR
Counselor (Addiction (Substance Use Disorder))
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412
PAOLA RUIZ MORA
Counselor (Addiction (Substance Use Disorder))
98 HENDLEY ST
SANTA ROSA, CA 95404
Sonoma County (707) 527-0412

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 Jennifer Wallace's NPI number?

The NPI number for Jennifer Wallace is 1508532953. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Where is Jennifer Wallace located?

Jennifer Wallace practices at 98 Hendley St, Santa Rosa, CA 95404. The listed phone number is (707) 527-0412.

What is Jennifer Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jennifer Wallace was last updated on July 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.