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

Johnny Michael Wallace

Individual provider Behavior Technician · NPI 1861073413

Johnny Michael Wallace is a Behavior Technician in San Francisco, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2021
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Practice location Address checks out

139 Hugo St Apt 3
San Francisco, CA 94122-2760
Phone: (310) 691-3644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5940 El Escorpion Rd, Woodland Hills, CA 91367-3923 — (818) 620-6005

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (CA)

Record details

NPI number1861073413
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 15, 2021
Last updated in NPPESApril 15, 2021
Certification dateApril 15, 2021

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