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

Samuel Robert Wallace-Douglas

Individual provider Behavior Technician · NPI 1679276257

Samuel Robert Wallace-Douglas is a Behavior Technician in Menifee, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

27990 Sherman Rd
Menifee, CA 92585-9155
Phone: (951) 309-9135
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1679276257
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 23, 2023
Last updated in NPPESMarch 23, 2023
Certification dateMarch 23, 2023
Mailing address5850 Granite Pkwy Ste 600, Plano, TX 75024-6753

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