LISA WALLACE RN
NPI 1720476641
Nurse Practitioner - Psychiatric/Mental Health in Mather, CA

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

Active since December 30, 2014

10535 HOSPITAL WAY, MATHER, CA 95655(916) 366-5336 Get Directions Write a Review

NPPES record last updated: November 12, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 12, 2021, Aug 14, 2019, Apr 12, 2018 and 2 more (5 updates tracked since 2017).

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About Lisa Wallace Rn NPPES

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

LISA WALLACE RN (NPI 1720476641) is an individual psychiatric/mental health provider in Mather, California, licensed in California (95006507) and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1720476641

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameLISA WALLACECredential: RN

Location Address10535 HOSPITAL WAYMather, CA 95655-4200

Mailing Address10535 Hospital WayMather, CA 95655-4200 · (916) 366-5336

Phone(916) 366-5336

Sole ProprietorNo

Enumeration DateDecember 30, 2014

Last NPPES UpdateNovember 12, 20215 updates tracked since enumeration

NPPES CertifiedNovember 12, 2021

✔ NPI 1720476641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95006507

Also ListedRegistered NurseTaxonomy 163W00000X · License 821591 (CA)

10535 HOSPITAL WAY, Mather, CA 95655

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Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%94 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.