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

Everett Wallace

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1528655107

Everett Wallace is an Addiction (Substance Use Disorder) Counselor in Indio, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

44374 Palm St
Indio, CA 92201-3117
Phone: (760) 342-6616
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CI30830920 (CA)

Record details

NPI number1528655107
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 29, 2020
Last updated in NPPESDecember 29, 2020
Certification dateDecember 29, 2020
Mailing address1488 E Ramon Rd Apt 129, Palm Springs, CA 92264-0828

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