Wallace, Traci L.

Wallace, Traci L. is an individual health care provider with primary practice located at 10811 Washington Blvd. Suite 280, Culver City CA 90066. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Wallace, Traci L. can be contacted via phone (310) 939-4297.

Contact Information

Primary practice address
10811 Washington Blvd. Suite 280 Culver City CA 90066
Phone: (310) 939-4297
Fax: (310) 745-2891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY14644 California

Profile Details

NPI number 1881630093
LBN Legal business name Wallace, Traci L.
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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