Jacob Wallace II
Counselor, Mental Health in Oakland, CA. Individual provider (NPI-1).
NPI number1386809697
StatusActive
Last updated in NPPESJul 25, 2008
Details
- NPI
- 1386809697
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jacob Wallace II
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 25, 2008
- Last updated
- Jul 25, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
4368 Lincoln AveOakland, CA 94602-2529
Phone 510-531-3111 · Fax 510-530-8083
Mailing address
3419 69th Ave Apt 102Oakland, CA 94605-2574
Phone 510-569-2552
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All 1,081 Mental Health Counselor providers in Oakland · All 20,942 providers in Oakland
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