Provider Demographics
NPI:1477052074
Name:DEWOLF, ALISON CLAIRE (CRNA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CLAIRE
Last Name:DEWOLF
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:MCLENNAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2199 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3101
Mailing Address - Country:US
Mailing Address - Phone:415-261-8798
Mailing Address - Fax:
Practice Address - Street 1:2025 MORSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2115
Practice Address - Country:US
Practice Address - Phone:916-973-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000863367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered