MRS. SUSAN O'BRIEN WALLACE PSY. D.
NPI 1295907392
Psychologist - Clinical in San Bernardino, CA

Q: What is Susan Wallace's NPI number?

The NPI number for Susan Wallace is 1295907392. It was assigned to this individual provider in the NPPES registry on March 28, 2008.

Q: What is Susan Wallace's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Susan Wallace was last updated on February 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 28, 2008

1454 E 2ND ST, SAN BERNARDINO, CA 92408(909) 382-7100 Get Directions Write a Review

NPPES record last updated: February 21, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 21, 2018, Jan 13, 2016 (2 updates tracked since 2016).

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About Mrs. Susan O'brien Wallace Psy. D. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SUSAN O'BRIEN WALLACE PSY. D. (NPI 1295907392) is an individual clinical provider in San Bernardino, California, licensed in California (PSY27744) and active in the NPI registry since March 2008.

NPPES Registry Identity

NPI1295907392

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameMRS. SUSAN O'BRIEN WALLACECredential: PSY. D.

Location Address1454 E 2ND STSan Bernardino, CA 92408-0118

Mailing Address530 S Lake Ave # 565Pasadena, CA 91101-3515 · (619) 665-7781

Phone(909) 382-7100

Sole ProprietorNo

Enumeration DateMarch 28, 2008

Last NPPES UpdateFebruary 21, 20182 updates tracked since enumeration

✔ NPI 1295907392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY27744

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

1454 E 2ND ST, San Bernardino, CA 92408

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAC HEALTH SYSTEM

Clinic/Center (Federally Qualified Health Center (FQHC))