What is Remedios Wallace's NPI number?

The NPI number assigned to this healthcare provider is 1639294341, enumerated as a individual on March 20, 2007.

Where is the provider located?

The provider is located at 1212 N CALIFORNIA ST STOCKTON, CA 95202 and the phone number is (209) 468-8842.

What is the provider's specialty?

The provider's specialty is Licensed Psychiatric Technician with taxonomy code 167G00000X.

PROF. REMEDIOS AGUADA WALLACE - NPI 1639294341 - Licensed Psychiatric Technician in Stockton, CA

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About Prof. Remedios Aguada Wallace NPPES

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

PROF. REMEDIOS AGUADA WALLACE (NPI 1639294341) is an individual licensed psychiatric technician in Stockton, California, licensed in California (PT24227) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1639294341

Entity TypeIndividualFemale

Primary Taxonomy167G00000X

Provider Legal NamePROF. REMEDIOS AGUADA WALLACE

Location Address1212 N CALIFORNIA STStockton, CA 95202-1552

Mailing Address1212 N California StStockton, CA 95202-1552 · (209) 468-8842

Phone(209) 468-8842

Sole ProprietorNo

Enumeration DateMarch 20, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1639294341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers

Taxonomy Code167G00000X

License✔ Licensed in CA · PT24227

Definition

An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.

1212 N CALIFORNIA ST, Stockton, CA 95202

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