Provider Demographics
NPI:1447796453
Name:BIFANO, ALYSON (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:BIFANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 QUIET HILLS FARM RD
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7308
Mailing Address - Country:US
Mailing Address - Phone:530-570-1989
Mailing Address - Fax:
Practice Address - Street 1:772 QUIET HILLS FARM RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-7308
Practice Address - Country:US
Practice Address - Phone:530-570-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical