Dr Traci L Wallace, PHD - Psychologist in Culver City, CA

Dr Traci L Wallace, PHD is a Psychologist based in Culver City, California. Dr Traci L Wallace is licensed to practice in California (license number PSY14644) and her current practice location is 10811 Washington Blvd., Suite 280, Culver City, California. She can be reached at her office (for appointments etc.) via phone at (310) 939-4297.

NPI number for Dr Traci L Wallace is 1881630093 and her current mailing address is 10811 Washington Blvd., Suite 280, Culver City, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1881630093.

Contact Information

Dr Traci L Wallace, PHD
10811 Washington Blvd., Suite 280,
Culver City, CA 90066
(310) 939-4297
(310) 745-2891

Map and Direction




Healthcare Provider's Profile

Full NameDr Traci L Wallace
GenderFemale
SpecialityPsychologist
Location10811 Washington Blvd., Culver City, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1881630093
  • Provider Enumeration Date: 06/22/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Traci L Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1881630093NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist PSY14644 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Traci L Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Traci L Wallace, PHD
10811 Washington Blvd., Suite 280,
Culver City, CA 90066

Ph: (310) 939-4297
Dr Traci L Wallace, PHD
10811 Washington Blvd., Suite 280,
Culver City, CA 90066

Ph: (310) 939-4297

Reviews and Comments


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