Provider Demographics
NPI:1396019741
Name:STRATTON, ALISA LIGUORI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:LIGUORI
Last Name:STRATTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:LIGUORI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:320 10TH ST STE 301
Mailing Address - Street 2:SANTA ROSA
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-5291
Mailing Address - Country:US
Mailing Address - Phone:707-527-0260
Mailing Address - Fax:
Practice Address - Street 1:320 10TH ST STE 301
Practice Address - Street 2:SANTA ROSA
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5291
Practice Address - Country:US
Practice Address - Phone:707-527-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24790103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist