DR. DENNIS W WALLSTROM PH.D.
NPI 1932152600
Psychologist in Patton, CA

Active since May 17, 2006PECOS Enrolled
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369(909) 425-7679(909) 425-6635 Get Directions Write a Review

NPPES record last updated: August 21, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Dennis W Wallstrom Ph.d. NPPES

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

DR. DENNIS W WALLSTROM PH.D. (NPI 1932152600) is an individual psychologist in Patton, California, licensed in California (PSY13058) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1990).

NPPES Registry Identity

NPI1932152600
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. DENNIS W WALLSTROMCredential: PH.D.
Location Address3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICEPatton, CA 92369
Mailing Address3102 E. Highland Avenue, Medical Staff OfficePatton, CA 92369 · (909) 425-7679 · Fax (909) 425-6635
Fax(909) 425-6635
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateMay 17, 2006
Last NPPES UpdateAugust 21, 2015
NPI 1932152600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY13058
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3102 E. HIGHLAND AVENUE, Patton, CA 92369

Other Identifiers 2

Medicare ID-Type UnspecifiedOPL130580
Medicare UPINPSYCH

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Dennis W Wallstrom Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153468038
PECOS Enrollment IDI20091026000496
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Internal Medicine
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Social Worker (Clinical)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Social Worker (Clinical)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Family Medicine
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
Psychologist (Clinical)
3102 E. HIGHLAND AVENUE, PATTON STATE HOSPITAL
PATTON, CA 92369

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 Dennis Wallstrom's NPI number?

The NPI number for Dennis Wallstrom is 1932152600. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Dennis Wallstrom located?

Dennis Wallstrom practices at 3102 E. Highland Avenue Medical Staff Office, Patton, CA 92369. The listed phone number is (909) 425-7679.

What is Dennis Wallstrom's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Dennis Wallstrom enrolled in Medicare?

Yes. Dennis Wallstrom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dennis Wallstrom was last updated on August 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.