Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER | |
2200 N Sepulveda Blvd, Manhattan Beach, CA 90266-2910 | |
(310) 802-0200 | |
(310) 794-9035 |
Full Name | Ms Jessica Elizabeth Wallace |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 27 Years |
Location | 2200 N Sepulveda Blvd, Manhattan Beach, California |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215981170 | NPI | - | NPPES |
RN547962 | Other | CA | MEDICAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 547962 (California) | Primary |
363LF0000X | Nurse Practitioner - Family | 10241 (California) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Ronald Reagan Ucla Medical Center | Los angeles, CA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Ucla Radiology Medical Group | 8921902065 | 182 |
Entity Name | Ucla Radiology Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881670248 PECOS PAC ID: 8921902065 Enrollment ID: O20031120001026 |
Entity Name | Martin Luther King Jr Community Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356899777 PECOS PAC ID: 8628359502 Enrollment ID: O20170109001311 |
Mailing Address | Practice Location Address |
---|---|
Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER 5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631 Ph: () - | Ms Jessica Elizabeth Wallace, NURSE PRACTITIONER 2200 N Sepulveda Blvd, Manhattan Beach, CA 90266-2910 Ph: (310) 802-0200 |
Mrs. Christine Louise Constable, MSN, WHNP-BC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1805 Wendy Way, Manhattan Beach, CA 90266 Phone: 310-487-7002 | |
Jeffrey Marchesani, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1601 N Sepulveda Blvd, Ste 216, Manhattan Beach, CA 90266 Phone: 310-393-7654 | |
Traci Neri, RN BSN IBCLC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3405 Pine Ave, Manhattan Beach, CA 90266 Phone: 310-849-3347 | |
Claire Manning, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1145 N Poinsettia Ave, Manhattan Beach, CA 90266 Phone: 415-658-1280 | |
Mrs. Ann Tucker Jones, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2201 Magnolia Ave, Manhattan Beach, CA 90266 Phone: 310-753-4153 Fax: 310-545-7294 | |
Victoria Hirst, FNP-BC, RN Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 2900 N Sepulveda Blvd, Manhattan Beach, CA 90266 Phone: 866-389-2727 |