JOANNA L WALLACE PHD
NPI 1811058431
Clinical Neuropsychologist in Palo Alto, CA

Q: What is Joanna Wallace's NPI number?

The NPI number for Joanna Wallace is 1811058431. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Q: What is Joanna Wallace's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Joanna Wallace was last updated on August 14, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 13, 2006PECOS Enrolled

725 WELCH RD, PALO ALTO, CA 94304(650) 497-8000 Get Directions Write a Review

NPPES record last updated: August 14, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Joanna L Wallace Phd NPPES

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

JOANNA L WALLACE PHD (NPI 1811058431) is an individual clinical neuropsychologist in Palo Alto, California, licensed in California (26254) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811058431

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameJOANNA L WALLACECredential: PHD

Location Address725 WELCH RDPalo Alto, CA 94304-1601

Mailing Address725 Welch RdPalo Alto, CA 94304-1601 · (650) 497-8000

Phone(650) 497-8000

Sole ProprietorNo

Enumeration DateDecember 13, 2006

Last NPPES UpdateAugust 14, 2023

NPPES CertifiedAugust 14, 2023

✔ NPI 1811058431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in CA · 26254

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

725 WELCH RD, Palo Alto, CA 94304

Open in Google Maps ↗

Other Names 1

Other Name (5)Jo L Wallace Phd

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joanna L Wallace Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.