La Tanya Wallace
FNP | Nurse Practitioner | 13+ years Exp
6921 Sperry Ct, San Diego
California, 92111-7030
858-717-0164
Accepts Medicare Nurse Anesthetist in San Diego, California.La Tanya Wallace is a San Diego, California based nurse practitioner with 13 years of experience in Nurse Practitioner. She completed her graduation from Western University Of Health Sciences College Of Dental Med in 2012. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of La Tanya Wallace is 22485 for Psych/Mental Health in California. Her current practice location is 6921 Sperry Ct, San Diego. Patients can reach her at 858-717-0164 or can fax her at 888-425-0508. La Tanya Wallace is FNP with specialization in Nurse Practitioner and her NPI number (Unique professional ID assigned by NPPES) is 1841453487.
La Tanya Wallace has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
La Tanya Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | La Tanya Wallace |
| Specialization: | Nurse Practitioner Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | FNP |
| Experience: | 13+ years |
| Medical School Attended: | Western University Of Health Sciences College Of Dental Med |
| Graduation Year: | 2012 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 6921 Sperry Ct, San Diego, California, 92111-7030 |
| Phone: | 858-717-0164 |
| Fax: | 888-425-0508 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 7416253075 |
| Enrollment ID: | I20201008002138 |
| NPI Number: | 1841453487 |
| NPI Enumeration Date: | 03 Jul, 2008 |
| NPI Last Update On: | 28 Jan, 2024 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for La Tanya Wallace are as mentioned below.
| License Number | Specialization | State | Status | |
| 22485 | Psych/Mental Health | California | Primary | |
| 680663 | Registered Nurse | California | Secondary | |
| 22485 | Nurse Practitioner | California | Secondary | |
| 680663 | Family | California | Secondary | |
| 22485 | Family | California | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with La Tanya Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 680663 | Other | California | CA BRN |
| 22485 | Other | California | BOARD OF REGISTERED NURSING |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | La Tanya Wallace 6921 Sperry Ct, San Diego, California |
| Zip: | 92111-7030 |
| Phone Number: | 858-717-0164 |
| Fax Number: | 888-425-0508 |
Patients can reach La Tanya Wallace at
6921 Sperry Ct, San Diego, California or can
call to book an appointment on 858-717-0164.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.