Provider Demographics
NPI:1295220408
Name:HART, ALLISON (PHD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S LIVERMORE AVE
Mailing Address - Street 2:UNIT 2048
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-3022
Mailing Address - Country:US
Mailing Address - Phone:925-719-1606
Mailing Address - Fax:
Practice Address - Street 1:707 SANDPIPER CMN
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-2664
Practice Address - Country:US
Practice Address - Phone:925-315-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical