Provider Demographics
NPI:1275586935
Name:WEBER, ALISON MARY (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MARY
Last Name:WEBER
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 7127
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0712
Mailing Address - Country:US
Mailing Address - Phone:707-252-7921
Mailing Address - Fax:707-252-7921
Practice Address - Street 1:1100 TRANCAS STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2904
Practice Address - Country:US
Practice Address - Phone:707-253-5306
Practice Address - Fax:707-252-7921
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17578103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
EF018AOtherMEDICARE PART B
EF018AOtherMEDICARE PART B
P60151Medicare UPIN