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

Miss. Evelyn Wallace, REGISTEREDNURSE

Individual provider Nursing Home Administrator · NPI 1063085116

Miss. Evelyn Wallace, REGISTEREDNURSE is a Nursing Home Administrator in Orange, California. Practices as a sole proprietor. Licensed in California.

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

2204 E Deborah Ln
Orange, CA 92869-4620
Phone: (714) 336-3712
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Home Administrator (primary) Taxonomy 376G00000X · Licence 300613124 (CA)

Record details

NPI number1063085116
Entity typeIndividual (Type 1)
GenderFemale
Credentials REGISTEREDNURSE
Sole proprietorYes
NPI enumeratedJuly 16, 2021
Last updated in NPPESJuly 16, 2021
Certification dateJuly 16, 2021

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