Mr. Divier J Wallace, MA/MFTI
Mr. Divier J Wallace, MA/MFTI is a Case Manager/Care Coordinator in San Leandro, California. Licensed in California. Registered with an NPI since 2011.
- Licensed in
- CA
- In the registry since
- 2011
- Specialties on file
- 3
Practice location Address checks out
400 Estudillo Ave Ste 100San Leandro, CA 94577-4962
Phone: (510) 924-0548
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|---|
| Case Manager/Care Coordinator | Taxonomy 171M00000X |
| Marriage & Family Therapist | Taxonomy 106H00000X · Licence 61914 (CA) |
Record details
| NPI number | 1750674388 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MA/MFTI |
| Sole proprietor | No |
| NPI enumerated | May 16, 2011 |
| Last updated in NPPES | June 17, 2021 |
| Certification date | June 17, 2021 |
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