NPI 1063085116

Evelyn Wallace, REGISTEREDNURSE

Practitioner Nursing Home Administrator Orange, CA

Practice location

Address: 2204 E Deborah Ln, Orange, CA 92869-4620
Phone: (714) 336-3712
Mailing address: 2906 E Hoover Ave, Orange, CA 92867-6253

Registered specialties

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X Licence 300613124 (CA)

Other Nursing Home Administrator providers in California →

Registry record

NPI: 1063085116
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jul 2021
Record last updated: 16 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.