| Doctor Name: | DR. R. DAVID WHEELER |
| NPI Number: | 1619147444 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | PSY 17303 |
| Business Practice Address: | California State Prison - Sacramento 100 Prison Road Represa, CA - 956713000 |
| Business Phone Number: | 9162943175 |
| Business Fax Number: | 9162943122 |
| Mailing Address: | 100 Prison Road, California State Prison - Sacramento REPRESA |
| State: | CA |
| Postal Code: | 956713000 |
| Phone Number: | 9162943175 |
| Fax Number: | 9162943122 |
| NPI Enumeration Date: | 03/07/2008 |
| NPI Last Update Date: | 03/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 17303 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |