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Ishmiel Wallace
NPI 1629709373 · Behavior Technician · Garden Grove, CA
Ishmiel Wallace is a Behavior Technician provider in Garden Grove, CA (NPI 1629709373).
Provider details
- NPI number
- 1629709373
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12465 Lewis St Ste 102
Garden Grove, CA 92840-4658
Phone: (855) 223-7123
Street-level locationGet directions
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Registry dates
- Enumerated
- 2022-06-23
- Last updated
- 2022-06-23
- Certified
- 2022-06-23
Frequently asked questions
- What is Ishmiel Wallace's NPI number?
- Ishmiel Wallace's National Provider Identifier (NPI) is 1629709373, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ishmiel Wallace's specialty?
- Ishmiel Wallace is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Ishmiel Wallace located?
- Ishmiel Wallace's practice location on file with NPPES is 12465 Lewis St Ste 102, Garden Grove, CA 92840-4658.
- What is Ishmiel Wallace's phone number?
- The practice phone number listed in the NPPES registry for Ishmiel Wallace is (855) 223-7123.
- Is Ishmiel Wallace's NPI active?
- Yes — Ishmiel Wallace's NPI (1629709373) is active in the NPPES registry as of the last update on 2022-06-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.