Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kenneth C Wallis, MD

Individual provider Psychiatry Physician · NPI 1649243692

Dr. Kenneth C Wallis, MD is a Psychiatry Physician in Davis, California. Works from 2 locations. Licensed in California and Utah.

Licensed in
CA, UT
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1260 Lake Blvd Ste #214
Davis, CA 95616-2614
Phone: (530) 771-2308
Fax: (530) 771-2309
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 40925 County Center Dr Ste 2002nd, Temecula, CA 92591-6054 — (951) 600-6300

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 811674181205 (UT)
Psychiatry Physician Taxonomy 2084P0800X · Licence C-41960 (CA)

Record details

NPI number1649243692
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 9, 2006
Last updated in NPPESJuly 9, 2021
Certification dateJuly 9, 2021
Mailing address1260 Lake Blvd, Suite #214, Davis, CA 95616-2614

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