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

Lisa Wallace, RN

Individual provider Registered Nurse · NPI 1720476641

Lisa Wallace, RN is a Registered Nurse in Mather, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Practice location Address checks out

10535 Hospital Way
Mather, CA 95655-4200
Phone: (916) 366-5336
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95006507 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 821591 (CA)

Record details

NPI number1720476641
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedDecember 30, 2014
Last updated in NPPESNovember 12, 2021
Certification dateNovember 12, 2021
Mailing address10535 Hospital Way, Mather, CA 95655-4200

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