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Ian Wallace, PH.D
NPI 1013143262 · on the registry since 2009
Practice
- Address
- 200 Maritime Academy Dr
The California Maritime Academy, Student Health Service
Vallejo, CA 94590 - Phone
- (707) 654-1170
- Fax
- (707) 654-1171
- Organisation at this address
- California Maritime Academy
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- Psychologist
103T00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-07-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California