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

Jessica Wallace

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1073940888

Jessica Wallace is a Student in an Organized Health Care Education/Training Program in Poway, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2013
Specialties on file
2

Practice location Address checks out

15611 Pomerado Rd Ste 535
Poway, CA 92064-2437
Phone: (858) 279-1223
Show map & directions

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

Additional practice locations (1)

  • 8376 Hercules St, La Mesa, CA 91942-2902 — (619) 667-6891

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 103283 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1073940888
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 11, 2013
Last updated in NPPESMarch 17, 2018
Mailing addressPo Box 3328, Ramona, CA 92065-0957

Other providers in Poway