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Active NPI 1013143262 Individual Practitioner Male Practitioner

Dr. Ian Joseph Wallace , PhD

Psychologist • Vallejo, CA

Professional Overview & Biography Verified Profile Summary

Dr. Ian Wallace, PhD is a registered healthcare professional specializing in Psychologist in Vallejo, CA. Practice services are available at 200 MARITIME ACADEMY DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

200 Maritime Academy Dr
The California Maritime Academy, Student Health Service

Vallejo, CA 945908181

Telephone 7076541170
Fax 7076541171
Associated Practice Facility / Clinic
🏢 California Maritime Academy Facility NPI 1073813341

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Vallejo, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.8 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
15 Specialists

Practicing in Vallejo, CA (7695 Statewide)

Telehealth Adoption Rate
20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License CA PSY# 23646

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Cathleen Coulman , MD

Internal Medicine

NPI 1689941171

Doctor of Medicine (M.D.)

Christine Smith , NURSE PRACTITIONER

Nurse Practitioner - Family

NPI 1902029879

NURSEPRACTITIONER

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 23, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2013

Registered at 200 MARITIME ACADEMY DR, THE CALIFORNIA MARITIME ACADEMY, STUDENT HEALTH SERVICE, VALLEJO, CA 945908181 (Tel: 7076541170)

📍
Updated Business Mailing Address July 23, 2013

Registered at 200 MARITIME ACADEMY DR, THE CALIFORNIA MARITIME ACADEMY, STUDENT HEALTH SERVICE, VALLEJO, CA 945908181 (Tel: 7076541170)

👤
Provider Name / Credentials Updated July 23, 2013

Recorded as IAN WALLACE, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2013

Psychologist (License #PSY# 23646 in CA)

🟢
Initial NPI Registration & Enumeration June 02, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013143262
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2009
Last Update: July 23, 2013
Sole Proprietor: No

Mailing Address

200 Maritime Academy Dr, The California Maritime Academy, Student Health Service

Vallejo, CA 945908181

Phone: 7076541170

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.