Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Angela Kathleen Wallace, MFT45450

Individual provider Marriage & Family Therapist · NPI 1417452731

Angela Kathleen Wallace, MFT45450 is a Marriage & Family Therapist in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018

Practice location Address checks out

554 S San Vicente Blvd Ste 200
Los Angeles, CA 90048-4651
Phone: (310) 862-4668
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 45450 (CA)

Record details

NPI number1417452731
Entity typeIndividual (Type 1)
GenderFemale
Credentials MFT45450
Sole proprietorYes
NPI enumeratedMarch 28, 2018
Last updated in NPPESMarch 28, 2018

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