MEDICARE: KAREN FRANCES WALLACE

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	235Z00000X	Speech-Language Pathologist	5285	CA

General Provider Information

NPI Number	:	1417886771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN FRANCES WALLACE

Provider Business Mailing Address
First Line	:	1522 W ADAMS ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5717
Country	:	US
Telephone Number	:	714-430-5809
Fax Number	:

Provider Business Practice Location Address
First Line	:	1522 W ADAMS ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5717
Country	:	US
Telephone Number	:	714-430-5809
Fax Number	:

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ KAREN FRANCES WALLACE ” Practice Location

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