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EVERETT WALLACE
NPI 1528655107
Counselor - Addiction (Substance Use Disorder) in Indio, CA

Active since December 29, 2020
44374 PALM ST, INDIO, CA 92201(760) 342-6616 Get Directions Write a Review

NPPES record last updated: December 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Everett Wallace NPPES

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

EVERETT WALLACE (NPI 1528655107) is an individual addiction (substance use disorder) provider in Indio, California, licensed in California (CI30830920) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1528655107
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameEVERETT WALLACE
Location Address44374 PALM STIndio, CA 92201-3117
Mailing Address1488 E Ramon Rd Apt 129Palm Springs, CA 92264-0828 · (901) 581-0817
Phone(760) 342-6616
Sole ProprietorYes
Enumeration DateDecember 29, 2020
NPPES CertifiedDecember 29, 2020
✔ NPI 1528655107 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 · CI30830920
44374 PALM ST, Indio, CA 92201
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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.

JULIE ANN EIDSON LVN
Licensed Vocational Nurse
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
JUSTIN VAUGHN FLORES
Counselor (Addiction (Substance Use Disorder))
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
ANTHONY EUGENE PITTS CPSS
Peer Specialist
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
LISA A WOLFE
Counselor (Addiction (Substance Use Disorder))
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
BRIAN SULLIVAN
Counselor (Addiction (Substance Use Disorder))
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
MRS. FREDA ANN ADDEO LMFT
Marriage & Family Therapist
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
KARYN SPRINKLE PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 342-6616
JANELLE MARIE HUGHES RADT
Case Manager/Care Coordinator
44374 PALM ST
INDIO, CA 92201
Riverside County (760) 992-2225

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 Everett Wallace's NPI number?

The NPI number for Everett Wallace is 1528655107. It was assigned to this individual provider in the NPPES registry on December 29, 2020.

Where is Everett Wallace located?

Everett Wallace practices at 44374 Palm St, Indio, CA 92201. The listed phone number is (760) 342-6616.

What is Everett 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 Everett Wallace was last updated on December 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.