MEDICARE: GIANA WALLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	APCC21591	CA

General Provider Information

NPI Number	:	1295681450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIANA WALLER

Provider Business Mailing Address
First Line	:	6160 MISSION GORGE RD STE 108
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-3425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 MISSION GORGE RD STE 108
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-3425
Country	:	US
Telephone Number	:	619-481-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ GIANA WALLER ” Practice Location

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