Provider Demographics
NPI:1386852887
Name:WALLS, DAVID ALLEN (MFCC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:WALLS
Suffix:
Gender:M
Credentials:MFCC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3969 4TH AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3165
Mailing Address - Country:US
Mailing Address - Phone:619-692-0441
Mailing Address - Fax:619-692-0442
Practice Address - Street 1:3969 4TH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3165
Practice Address - Country:US
Practice Address - Phone:619-692-0441
Practice Address - Fax:619-692-0442
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)