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

Diane Ruth Wallace, PTA

Individual provider Physical Therapy Assistant · NPI 1265642730

Diane Ruth Wallace, PTA is a Physical Therapy Assistant in LA Mesa, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

9000 Wakarusa St
LA Mesa, CA 91942-3307
Phone: (619) 740-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence AT250 (CA)

Record details

NPI number1265642730
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 23, 2007
Last updated in NPPESJuly 8, 2007

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