Healthcare Provider Details

I. General information

NPI: 1689882813
Provider Name (Legal Business Name): CALLAE WALCOTT-ROUNDS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 S EUCLID AVE
PASADENA CA
91101-2717
US

IV. Provider business mailing address

279 S EUCLID AVE
PASADENA CA
91101-2717
US

V. Phone/Fax

Practice location:
  • Phone: 626-578-7140
  • Fax: 626-578-7140
Mailing address:
  • Phone: 626-578-7140
  • Fax: 626-578-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY13952
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberPSY13952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: