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

Serena A Wallace, DPT

Individual provider Physical Therapist · NPI 1194407668

Serena A Wallace, DPT is a Physical Therapist in San Bernardino, California. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2023
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

275 W Hospitality Ln Ste 100
San Bernardino, CA 92408-3238
Phone: (909) 567-2221
Fax: (909) 763-3216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT61456638 (WA)

Record details

NPI number1194407668
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedAugust 3, 2023
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024

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