NPI

Lauralee Wallace

This page is a copy of the public NPPES file.

Facts

Status
Active
Type
Individual
Enumeration date
2020-10-20
Last updated
2020-10-20

Specialties

Licenses

License CA
PT20432

Location

Practice location
11239 Ball Mtn Little Shasta Rd
City
Montague CA
Postal code
96064-9682
Phone
(530) 340-1490

Medicare

PECOS
A PECOS enrollment row matches this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.

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Nearby

Other NPIs in Montague, CA. 14 records in the public file.

Removal request

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