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

Stephanie Celeste Wallace, PA-C

Individual provider Physician Assistant · NPI 1518104942

Stephanie Celeste Wallace, PA-C is a Physician Assistant in Vista, California. Qualified in 2005, 21 years ago. Practices with Women's Health Center of Southern Oregon PC, a 15-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone: (760) 631-5000
Fax: (760) 414-3892
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA19629 (CA)

Record details

NPI number1518104942
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 7, 2009
Last updated in NPPESSeptember 13, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Women'S Health Center Of Southern Oregon Pc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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