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

Debra R Wallace, NP

Individual provider Nurse Practitioner · NPI 1164570065

Debra R Wallace, NP is a Nurse Practitioner in Panorama City, California. Qualified in 1992, 34 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
34
Licensed in
CA
In the registry since
2007
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

13652 Cantara St
Panorama City, CA 91402-5423
Phone: (818) 375-2000
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 006248 (CA)

Record details

NPI number1164570065
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 8, 2007
Last updated in NPPESNovember 30, 2021
Mailing address13652 Cantara St, Panorama City, CA 91402-5423

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Panorama City