JORDAN CORNELL WALLACE
NPI 1689449787
Behavior Technician in Cathedral City, CA

Active since November 17, 2023
69155 DINAH SHORE DR, CATHEDRAL CITY, CA 92234(760) 969-9383 Get Directions Write a Review

NPPES record last updated: November 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Cornell Wallace NPPES

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

JORDAN CORNELL WALLACE (NPI 1689449787) is an individual behavior technician in Cathedral City, California and active in the NPI registry since November 2023.

NPPES Registry Identity

NPI1689449787
Entity TypeIndividualMale
Primary Taxonomy106S00000X
Provider Legal NameJORDAN CORNELL WALLACE
Location Address69155 DINAH SHORE DRCathedral City, CA 92234-4792
Mailing Address69155 Dinah Shore DrCathedral City, CA 92234-4792 · (760) 969-9383
Sole ProprietorYes
Enumeration DateNovember 17, 2023
NPPES CertifiedNovember 17, 2023
NPI 1689449787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers
Taxonomy Code106S00000X
Definition
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
69155 DINAH SHORE DR, Cathedral City, CA 92234

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 Jordan Wallace's NPI number?

The NPI number for Jordan Wallace is 1689449787. It was assigned to this individual provider in the NPPES registry on November 17, 2023.

Where is Jordan Wallace located?

Jordan Wallace practices at 69155 Dinah Shore Dr, Cathedral City, CA 92234. The listed phone number is (760) 969-9383.

What is Jordan Wallace's specialty?

The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.

When was this NPI record last updated?

The NPPES record for Jordan Wallace was last updated on November 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.