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

Jennifer Wallace, SUDRC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1508532953

Jennifer Wallace, SUDRC is an Addiction (Substance Use Disorder) Counselor in Santa Rosa, California. Licensed in California. Registered with an NPI since 2021.

Licensed in
CA
In the registry since
2021

Practice location Address checks out

98 Hendley St
Santa Rosa, CA 95404-5025
Phone: (707) 527-0412
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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 R1441130821 (CA)

Record details

NPI number1508532953
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDRC
Sole proprietorNo
NPI enumeratedAugust 17, 2021
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024

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