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DR. KENNETH C WALLIS M.D.
NPI 1649243692
Psychiatry & Neurology - Psychiatry in Davis, CA

Active since February 09, 2006
1260 LAKE BLVD, SUITE #214, DAVIS, CA 95616(530) 771-2308(530) 771-2309 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kenneth C Wallis M.d. NPPES

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

DR. KENNETH C WALLIS M.D. (NPI 1649243692) is an individual psychiatry provider in Davis, California, licensed in Utah (811674181205) and active in the NPI registry since February 2006. He maintains a secondary practice location in Temecula.

NPPES Registry Identity

NPI1649243692
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. KENNETH C WALLISCredential: M.D.
Location Address1260 LAKE BLVD, SUITE #214Davis, CA 95616-2614
Mailing Address1260 Lake Blvd, Suite #214Davis, CA 95616-2614 · (530) 771-2308 · Fax (530) 771-2309
Phone(530) 771-2308
Fax(530) 771-2309
Sole ProprietorNo
Enumeration DateFebruary 9, 2006
Last NPPES UpdateJuly 9, 2021
NPPES CertifiedJuly 9, 2021
✔ NPI 1649243692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in UT · 811674181205✔ Licensed in CA · C-41960
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1260 LAKE BLVD, Davis, CA 95616
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Secondary Practice Location 1

Location 140925 County Center Dr Ste 2002ndTemecula, CA 92591-6054 · Phone (951) 600-6300

Other Identifiers 3

Other261795UT · Deseret Mutual
Other107005564101UT · Intrmtn. Health Care
Other942938348WA1UT · Educators Mutual

Other Providers at the Same Location NPPES 7

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

MS. SUSAN LYNNE BLAINE MFT
Marriage & Family Therapist
1260 LAKE BLVD, SUITE 243
DAVIS, CA 95616
Yolo County (530) 297-1601
ROWAN E FOLEY LEP
Psychologist (School)
1260 LAKE BLVD, WL-228
DAVIS, CA 95616
Yolo County (530) 219-4309
BREAKTHROUGH EDUCATION SUPPORT
Psychologist (School)
1260 LAKE BLVD, WL-228
DAVIS, CA 95616
Yolo County (530) 219-4309
DONNA LISBETH HIRSCHFIELD MFT
Marriage & Family Therapist
1260 LAKE BLVD, SUITE #239
DAVIS, CA 95616
Yolo County (530) 756-5313
LINDA S MICHAEL PSY. D.
Psychologist (Clinical)
1260 LAKE BLVD, SUITE 224
DAVIS, CA 95616
Yolo County (510) 847-2982
DR. DIANE JOAN SOMMERS PH.D.
Psychologist
1260 LAKE BLVD, SUITE 217
DAVIS, CA 95616
Yolo County (530) 297-7757
JENIFER BUTERA LMFT
Marriage & Family Therapist
1260 LAKE BLVD, SUITE 242
DAVIS, CA 95616
Yolo County (530) 771-2308

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Wallis's NPI number?

The NPI number for Kenneth Wallis is 1649243692. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Where is Kenneth Wallis located?

Kenneth Wallis practices at 1260 Lake Blvd Suite #214, Davis, CA 95616. The listed phone number is (530) 771-2308.

What is Kenneth Wallis's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

When was this NPI record last updated?

The NPPES record for Kenneth Wallis was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.