Ayesha Wallace
- Affiliated sites
- 1
- Medical group
- 1
- State license
- 1
- Year NPI issued
- 2012
- Practice locations
- 2
- Practice address
- 710 E 111th Pl, Los Angeles, CA 90059
- Practice phone
- Call (323) 233-0425
- Professional email
- Get professional email
- Personal email
- Get personal email
- Mobile number
- Get mobile number
Primary practice
Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl)
Behavioral health practice · Los Angeles, California
Find Ayesha Wallace's professional email, personal email and mobile number
Dmand AI checks each channel through healthcare-specific waterfall enrichment. See what is on file with a free account, with practice phones, licenses and affiliations.
Ayesha Wallace is a clinical social worker in Los Angeles, California
Ayesha Wallace practices at Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl) in Los Angeles, California.
Ayesha Wallace's NPI, 1649522400, was assigned on October 3, 2012. Ayesha Wallace holds California license 79411.
- NPI
- 1649522400NPI Registry (opens in a new tab)
- NPI enumeration date
- October 3, 2012
- NPI status
- Active
- Practice phone
- (323) 233-0425
- Professional email
- Get email
- Personal email
- Get email
- Mobile number
- Get number
- Sex
- Female
Sources: NPPES NPI Registry (CMS); Dmand AI Professional Profile Data; Dmand AI Affiliation Data; and Doctors and Clinicians National Downloadable File (CMS)
Ayesha Wallace practices at 2 locations in Los Angeles, California
Ayesha Wallace's primary practice is Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl), at 710 E 111th Pl, Los Angeles, CA 90059. The practice phone is (323) 233-0425. The NPI Registry lists Ayesha Wallace's practice address as 4760 W Sunset Blvd, Los Angeles, CA 90027.
- Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl)Primary710 E 111th Pl, Los Angeles, CA 90059Phone(323) 233-0425
- NPI Registry address4760 W Sunset Blvd, Los Angeles, CA 90027 · Los Angeles County
Sources: NPPES NPI Registry (CMS); Dmand AI Affiliation Data; Doctors and Clinicians National Downloadable File (CMS); and Dmand AI Practice Data
Ayesha Wallace is affiliated with 1 site of care and 1 medical group
Ayesha Wallace's primary practice is Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl) in Los Angeles, California. The medical group on file is Southern California Permanente Medical Group.
Sources: Dmand AI Affiliation Data; and Doctors and Clinicians National Downloadable File (CMS)
Dmand AI tracks the EHR system at Ayesha Wallace's practice
Dmand AI tracks the electronic health record (EHR) system at each site where Ayesha Wallace practices. Vendor and product names are available with a free account.
| Site | EHR vendor and product |
|---|---|
| Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl) | Available with a free account |
Source: Dmand AI Technology Install Data
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Ayesha Wallace is one of 9,919 clinical social workers in California
Social worker is Ayesha Wallace's primary specialty in the NPI Registry, under taxonomy code 1041C0700X. The record also lists clinical. Ayesha Wallace is licensed in California.
Specialties and state licenses
- Clinical social worker, CaliforniaPrimary
Clinical social workers near Ayesha Wallace
Counts of clinical social workers with a Dmand AI profile, by place and practice. Each opens the list.
Sources: NPPES NPI Registry (CMS); Dmand AI Professional Profile Data; and Dmand AI Peer Benchmarks
Ayesha Wallace's patients have a median age of 29
Across all payers, Dmand AI patient panel data puts Ayesha Wallace's median patient age at 29, with 83% women.
Ayesha Wallace's patients across all payers
Dmand AI patient panel data covers Medicare, Medicaid and commercial patients.
Patient panel by age, all payers
Median age 29
Patient panel by sex, all payers
- Women83%
- Men17%
Source: Dmand AI Patient Panel Data
Sources for Ayesha Wallace's profile data
| Data on this page | Source |
|---|---|
| NPI, name, sex, specialty and licenses | NPPES NPI Registry (CMS) (opens in a new tab)Dmand AI Professional Profile Data |
| Practice locations and phone | NPPES NPI Registry (CMS) (opens in a new tab)Dmand AI Affiliation DataDoctors and Clinicians National Downloadable File (CMS) (opens in a new tab)Dmand AI Practice Data |
| Primary practice, affiliations and health system | Dmand AI Affiliation DataDoctors and Clinicians National Downloadable File (CMS) (opens in a new tab) |
| Medicare patients and the all-payer patient panel | Dmand AI Patient Panel Data |
| EHR at each practice site | Dmand AI Technology Install Data |
| Similar physicians | Dmand AI Affiliation Data |
Data last refreshed October 2026Report an inaccuracyRemove my information
FAQ
Frequently asked questions about Ayesha Wallace
Spotted something out of date? Email hello@dmand.ai and we will check the record. Contact details live in the free trial.
What is Ayesha Wallace's NPI number?
Ayesha Wallace's NPI number is 1649522400. It was assigned on October 3, 2012, and it is active in the NPI Registry.
What does Ayesha Wallace specialize in?
Ayesha Wallace is a clinical social worker in Los Angeles, California. The primary specialty in the NPI Registry is Clinical Social Worker (taxonomy code 1041C0700X).
Where does Ayesha Wallace practice?
Ayesha Wallace practices at 710 E 111th Pl, Los Angeles, CA 90059. Ayesha Wallace also practices at 4760 W Sunset Blvd, Los Angeles, CA 90027. Ayesha Wallace's primary practice is Southern California Permanente Medical Group - Behavioral & Mental Health - Los Angeles (E 111th Pl) in Los Angeles, California.
What is Ayesha Wallace's office phone number?
The practice phone on file for Ayesha Wallace is (323) 233-0425.
What is Ayesha Wallace's medical license number?
Ayesha Wallace holds California license 79411.
What medical group is Ayesha Wallace part of?
Ayesha Wallace is linked to Southern California Permanente Medical Group.
How long has Ayesha Wallace been practicing?
Ayesha Wallace's NPI was assigned in 2012.
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