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Kenneth Wallis, M.D
NPI 1649243692 · on the registry since 2006
Practice
- Address
- 1260 Lake Blvd
Suite #214
Davis, CA 95616 - Phone
- (530) 771-2308
- Fax
- (530) 771-2309
- Organisation at this address
- Breakthrough Education Support
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 11
Additional practice sites
- 40925 County Center Dr Ste 2002nd, Temecula, CA
Registry record
- Primary taxonomy
- Psychiatry
2084P0800X
- Also registered as
- Psychiatry
- Licence states on file
- CA, UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-07-09
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