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

Individual provider Behavior Analyst · NPI 1679713754

Mr. Jason D Wallace, BCBA is a Behavior Analyst in Oldsmar, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2009
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

104 Shoreview Ln
Oldsmar, FL 34677-4106
Phone: (813) 546-9867
Fax: (813) 818-0510
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-04-1845 (FL)

Record details

NPI number1679713754
Entity typeIndividual (Type 1)
GenderMale
Credentials BCBA
Sole proprietorYes
NPI enumeratedMarch 2, 2009
Last updated in NPPESMarch 2, 2009
Mailing address104 Shoreview Ln, Oldsmar, FL 34677-4106

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