Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum
Dr. Kenneth C Wallis, M.D.
Psychiatry Physician in Davis, CA · enumerated 2006.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1649243692
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Registry record
Entity type Individual (Type 1)
Name Dr. Kenneth C Wallis
Credential M.D.
Sex Male
Practice address 1260 Lake Blvd, Suite #214, Davis, CA, 95616
Phone (530) 771-2308
Fax (530) 771-2309
Enumeration date Feb 9, 2006
Last updated in NPPES Jul 9, 2021
Taxonomy & licenses
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians · License C-41960 (CA) Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians · License 811674181205 (UT) Primary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure.
About the MD credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107005564101 | Other | UT | INTRMTN. HEALTH CARE |
| 261795 | Other | UT | DESERET MUTUAL |
| 942938348WA1 | Other | UT | EDUCATORS MUTUAL |
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.
Frequently asked questions
What specialty is Kenneth Wallis?
Kenneth Wallis is registered in NPPES with the primary taxonomy of Psychiatry Physician. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.
Is this the official NPI registry?
No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.
Other providers at this practice address
Browse all → Susan Blaine Marriage & Family Therapist · Davis, CA NPI 1174542666 Diane Sommers Psychologist · Davis, CA NPI 1801940994 Linda Michael Clinical Psychologist · Davis, CA NPI 1679608871 Donna Hirschfield Marriage & Family Therapist · Davis, CA NPI 1508981192 Jenifer Butera Marriage & Family Therapist · Davis, CA NPI 1982925616 Rowan Foley School Psychologist · Davis, CA NPI 1225713845
Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-07-09.