Latrina Wallace, is a
Community Health Worker based in Barstow, California. Latrina Wallace is licensed to practice in * (Not Available) (license number ) and her current practice location is
312 Grove Ave, Barstow, California. She can be reached at her office (for appointments etc.) via phone at
(443) 891-4970.
NPI number for Latrina Wallace is 1124581327 and her current mailing address is 312 Grove Ave, Barstow, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124581327.
Healthcare Provider's Profile
| Full Name | Latrina Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 312 Grove Ave, Barstow, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1124581327
- Provider Enumeration Date: 04/13/2019
- Last Update Date: 07/24/2025
Medical Identifiers
Medical identifiers for Latrina Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124581327 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 174H00000X | Health Educator | (* (Not Available)) | Secondary |
| 225C00000X | Rehabilitation Counselor | (* (Not Available)) | Secondary |
| 372600000X | Adult Companion | (* (Not Available)) | Secondary |
| 374U00000X | Home Health Aide | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latrina Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Latrina Wallace,
312 Grove Ave,
Barstow, CA 92311-5449
Ph: (443) 891-4970 | Latrina Wallace,
312 Grove Ave,
Barstow, CA 92311-5449
Ph: (443) 891-4970 |
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