Provider Demographics
NPI:1164952404
Name:ANDERSON, ALLISON DUNCAN (CADC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:DUNCAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44359 PALM ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-3116
Mailing Address - Country:US
Mailing Address - Phone:760-989-0334
Mailing Address - Fax:
Practice Address - Street 1:44359 PALM ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3116
Practice Address - Country:US
Practice Address - Phone:760-989-0334
Practice Address - Fax:760-989-0334
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC18491214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)