Provider Demographics
NPI:1275830275
Name:GRACIA, ALISON P (MA,LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:P
Last Name:GRACIA
Suffix:
Gender:F
Credentials:MA,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12572 FIELDSTONE LN APT 92
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2977
Mailing Address - Country:US
Mailing Address - Phone:714-418-5966
Mailing Address - Fax:
Practice Address - Street 1:10602 CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-3146
Practice Address - Country:US
Practice Address - Phone:714-532-8300
Practice Address - Fax:714-532-7945
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist