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

Miss. Elise La Keisha Wallace, 172V00000X

Individual provider Community Health Worker · NPI 1376079558

Miss. Elise La Keisha Wallace, 172V00000X is a Community Health Worker in Compton, California. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

921 E Compton Blvd
Compton, CA 90221-3303
Phone: (310) 668-6947
Fax: (310) 898-1607
Show map & directions

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

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X

Record details

NPI number1376079558
Entity typeIndividual (Type 1)
GenderFemale
Credentials 172V00000X
Sole proprietorYes
NPI enumeratedMay 5, 2017
Last updated in NPPESMay 5, 2017

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