Provider Demographics
NPI:1124203534
Name:ANDERSON, ALLISON KAY
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:KAY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10840 CALVINE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95830-9318
Mailing Address - Country:US
Mailing Address - Phone:916-410-8011
Mailing Address - Fax:
Practice Address - Street 1:1507 21ST ST STE 205
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5297
Practice Address - Country:US
Practice Address - Phone:916-410-8011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health