MRS. SUSAN O'BRIEN WALLACE PSY. D. NPI 1295907392

NPI Information

  • NPI: 1295907392
  • Provider Name: MRS. SUSAN O'BRIEN WALLACE, PSY. D.
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 1454 E 2ND ST
    SAN BERNARDINO, CA
    ZIP 92408
  • Phone: (909) 382-7100

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NPI Details

MRS. Susan O'brien Wallace, PSY. D. is a clinical psychologist in San Bernardino, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. MRS. Susan O'brien Wallace, PSY. D. NPI is 1295907392. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1454 E 2ND ST
SAN BERNARDINO, CA
ZIP 92408-118
Phone: (909) 382-7100

The enumeration date for this NPI number is 3/28/2008 and was last updated on 2/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2103TC0700XPsychologistClinicalPSY27744CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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