MRS. SUSAN VICTORIA WALLACE CLINICIAN
NPI 1710247812
Marriage & Family Therapist in Riverside, CA

Q: What is Susan Wallace's NPI number?

The NPI number for Susan Wallace is 1710247812. It was assigned to this individual provider in the NPPES registry on May 22, 2012.

Q: What is Susan Wallace's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Wallace was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 22, 2012

3576 ARLINGTON AVE STE 106, RIVERSIDE, CA 92506(951) 788-5905 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mrs. Susan Victoria Wallace Clinician NPPES

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

MRS. SUSAN VICTORIA WALLACE CLINICIAN (NPI 1710247812) is an individual marriage & family therapist in Riverside, California, licensed in California (MFC45089) and active in the NPI registry since May 2012. She maintains a secondary practice location in San Bernardino.

NPPES Registry Identity

NPI1710247812

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMRS. SUSAN VICTORIA WALLACECredential: CLINICIAN

Location Address3576 ARLINGTON AVE STE 106Riverside, CA 92506-3907

Mailing Address9685 Hayes StRiverside, CA 92503-3660 · (951) 351-4418

Phone(951) 788-5905

Sole ProprietorNo

Enumeration DateMay 22, 2012

Last NPPES UpdateMarch 1, 2022

NPPES CertifiedMarch 1, 2022

✔ NPI 1710247812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · MFC45089

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

3576 ARLINGTON AVE STE 106, Riverside, CA 92506

Open in Google Maps ↗

Secondary Practice Location 1

Location 1255 N D St Ste 412San Bernardino, CA 92401-1715 · Phone (951) 788-5905

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.

DANIEL J KENNEY

Peer Specialist