Provider Demographics
NPI:1417611278
Name:US ALLIANCE LLC
Entity Type:Organization
Organization Name:US ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:916-886-7996
Mailing Address - Street 1:12783 EVANSTON WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-7803
Mailing Address - Country:US
Mailing Address - Phone:916-886-7996
Mailing Address - Fax:
Practice Address - Street 1:12783 EVANSTON WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-7803
Practice Address - Country:US
Practice Address - Phone:916-886-7996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health