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LA TANYA WALLACE FNP
NPI 1841453487
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Active since July 03, 2008PECOS EnrolledAccepts Medicare Assignment
6921 SPERRY CT, SAN DIEGO, CA 92111(858) 717-0164(888) 425-0508 Get Directions Write a Review

NPPES record last updated: January 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 20, 2022, Sep 29, 2021, Aug 20, 2021 and 3 more (6 updates tracked since 2016).

About La Tanya Wallace Fnp NPPES

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

LA TANYA WALLACE FNP (NPI 1841453487) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (22485) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1841453487
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLA TANYA WALLACECredential: FNP
Location Address6921 SPERRY CTSan Diego, CA 92111-7030
Mailing Address6921 Sperry CtSan Diego, CA 92111-7030 · (858) 717-0164 · Fax (888) 425-0508
Phone(858) 717-0164
Fax(888) 425-0508
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 3, 2008
Last NPPES UpdateJanuary 28, 20246 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2024
✔ NPI 1841453487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 22485
Also ListedRegistered NurseTaxonomy 163W00000X · License 680663 (CA)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 22485 (CA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 680663 (CA), 22485 (CA)
6921 SPERRY CT, San Diego, CA 92111
Open in Google Maps ↗

Other Identifiers 2

Other680663CA · Ca Brn
Other22485CA · Board Of Registered Nursing

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, BridgeSpan Health Company, Oscar Health Maintenance Organization of Florida and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

La Tanya Wallace Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416253075
PECOS Enrollment IDI20201008002138
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 La Tanya Wallace's NPI number?

The NPI number for La Tanya Wallace is 1841453487. It was assigned to this individual provider in the NPPES registry on July 3, 2008.

Where is La Tanya Wallace located?

La Tanya Wallace practices at 6921 Sperry Ct, San Diego, CA 92111. The listed phone number is (858) 717-0164.

What is La Tanya Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is La Tanya Wallace enrolled in Medicare?

Yes. La Tanya Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does La Tanya Wallace accept?

Health plans from Blue Cross and Blue Shield of Texas, BridgeSpan Health Company, Oscar Health Maintenance Organization of Florida, Oscar Insurance Company and Regence BlueCross BlueShield of Oregon and 1 other insurer list La Tanya Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for La Tanya Wallace was last updated on January 28, 2024. 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.