Provider Demographics
NPI:1134280431
Name:KLEIN, ALLYSON LESLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:LESLIE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 JUNIPERO SERRA BLVD
Mailing Address - Street 2:#650
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3891
Mailing Address - Country:US
Mailing Address - Phone:650-991-6200
Mailing Address - Fax:650-991-6103
Practice Address - Street 1:2001 JUNIPERO SERRA BLVD
Practice Address - Street 2:#650
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-3891
Practice Address - Country:US
Practice Address - Phone:650-991-6200
Practice Address - Fax:650-991-6103
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS208151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical