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

Mr. Jason Scott Wallace, PTA

Individual provider Physical Therapy Assistant · NPI 1891786646

Mr. Jason Scott Wallace, PTA is a Physical Therapy Assistant in Camarillo, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2486 N Ponderosa Dr Ste D-106
Camarillo, CA 93010-2376
Phone: (805) 484-5447
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence AT5146 (CA)

Record details

NPI number1891786646
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedNovember 1, 2005
Last updated in NPPESJuly 13, 2026

Other providers in Camarillo