WALTER (RUSTY) WALLACE OTTO


Address: 1970 University Park Drive, Sacramento, CA 95825
Phone: 9168045087

WALTER (RUSTY) WALLACE OTTO (NPI# 1649682469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649682469
Entity Type Individual
Full Name WALTER (RUSTY) WALLACE OTTO
Credential PHD
Practice Address 1970 University Park Drive
Sacramento
CA 95825
Practice Telephone 9168045087
Mailing Telephone 9168045087
Enumeration Date 2014-05-28
Last Update Date 2014-05-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist PSY12396 CA Behavioral Health & Social Service Providers

Office Location

Street Address 1970 UNIVERSITY PARK DRIVE
City SACRAMENTO
State CA
Zip Code 95825

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528667854 Sarah Claudio Case Manager/Care Coordinator 650 Howe Ave # 400-b, Sacramento, CA 95825 2020-10-19
1962009308 Andrea Isabel Morales Behavior Technician 333 University Avenue, Suite 200, Sacramento, CA 95825 2020-10-08
1942810510 Melissa Marlene Lowndes Occupational Therapist 1337 Howe Ave Unit 107, Sacramento, CA 95825 2020-08-07
1780294827 Travis Elliott Peppers Case Manager/Care Coordinator 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 2020-08-04
1154950327 Hallie Wenz Behavior Technician 333 University Ave Suite #200, Sacramento, CA 95825 2020-04-08
1679105456 Dr. Page Hudson Dental Corporation Dentist 1580 Howe Avenue, Suite A, Sacramento, CA 95825 2020-02-10
1710517891 Amelia Garnica Community/Behavioral Health 720 Howe Avenue, Suite 102, Sacamento, CA 95825 2020-01-17
1427697374 Anthony Barnes Social Worker 2008 Morse Avenue, Commons Building, Sacramento, CA 95825 2019-12-24
1528604519 Mental Health America of Northern California Community/Behavioral Health 720 Howe Ave., Suite 102, Cacramento, CA 95825 2019-11-25
1164068144 Mental Health America of Northern California Community/Behavioral Health 720 Howe Ave. Suite, 102, Sacramento, CA 95825 2019-11-25
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy 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.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669098885 Alexander Laszlo Peterkin Psychologist 4500 Truxel Rd Apt 834, Sacramento, CA 95834-3739 2020-06-23
1548881667 Jene Edwards Psychologist 3090 Fite Cir Ste 102, Sacramento, CA 95827-1810 2020-04-29
1215597968 Kaitlyn Hoitomt Psychologist 3331 Power Inn Rd # 140, Sacramento, CA 95826-3889 2019-06-15
1215452925 Tiffany Chang Psychologist 1500 W El Camino Ave # 420, Sacramento, CA 95833-1945 2017-08-03
1699220046 Kira Christensen Psychologist 3630 Winding Creek Rd, Sacramento, CA 95864-1531 2016-08-15
1932565769 First Love Yourself Inc. Psychologist 3425 1st Ave, Apartment 4, Sacramento, CA 95817-2034 2016-01-09
1912332107 Laura Magdalen Tully Psychologist 4701 X St, Uc Davis Imaging Research Center, Sacramento, CA 95817-2219 2013-09-06
1154763936 Jonathan Preiss Psychologist 801 Alhambra Blvd Ste 2b, Sacramento, CA 95816-4432 2013-07-22
1700165016 Donald Lawrence Salz Psychologist 2540 Land Park Dr, Sacramento, CA 95818-2244 2011-08-04
1417249269 Clary Tepper Psychologist 2509 Capitol Avenue, Sacramento, CA 95816 2011-05-12
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Competitor

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City SACRAMENTO
Zip Code 95825

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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