Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jane Oliver Wallis, MS-SLP

Individual provider Speech-Language Pathologist · NPI 1255685590

Jane Oliver Wallis, MS-SLP is a Qualified Speech Language Pathologist in Antioch, California. Qualified in 2011, 15 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Licensed in
CA
In the registry since
2012
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Practice location Address checks out

4501 Sand Creek Rd
Antioch, CA 94531-8687
Phone: (925) 813-6420
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 7414 (CA)

Record details

NPI number1255685590
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS-SLP
Sole proprietorYes
NPI enumeratedNovember 8, 2012
Last updated in NPPESJanuary 13, 2022
Certification dateJanuary 13, 2022

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Antioch