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

Olufunmi Osanemoh Wallace

Individual provider Licensed Vocational Nurse · NPI 1265321426

Olufunmi Osanemoh Wallace is a Licensed Vocational Nurse in Los Angeles, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

12029 Avalon Blvd
Los Angeles, CA 90061-2838
Phone: (323) 756-8191
Show map & directions

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

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence VN739159 (CA)

Record details

NPI number1265321426
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 1, 2025
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025

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