Provider Demographics
NPI:1508335514
Name:BAUMANN, ALLISON KATHLEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:KATHLEEN
Last Name:BAUMANN
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 1:436 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-1807
Mailing Address - Country:US
Mailing Address - Phone:650-733-6708
Mailing Address - Fax:
Practice Address - Street 1:417 TASSO ST # 2
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1545
Practice Address - Country:US
Practice Address - Phone:650-733-6708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA855301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty