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

Kevin Wallace

Individual provider Massage Therapist · NPI 1518391135

Kevin Wallace is a Massage Therapist in Modesto, California. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013

Practice location Address checks out

817 Coffee Rd Ste D
Modesto, CA 95355-4241
Phone: (209) 527-6100
Show map & directions

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

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 48846 (CA)

Record details

NPI number1518391135
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 30, 2013
Last updated in NPPESAugust 30, 2013
Mailing address817 Coffee Rd Ste D, Modesto, CA 95355-4241

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