Provider Demographics
NPI:1518697994
Name:LUCCHESE, ALLISON STEPHANIE (MA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:STEPHANIE
Last Name:LUCCHESE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:STEPHANIE
Other - Last Name:LUCCHESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21031 VENTURA BLVD STE 316
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2293
Mailing Address - Country:US
Mailing Address - Phone:818-497-6086
Mailing Address - Fax:
Practice Address - Street 1:20501 VENTURA BLVD STE 395
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-6438
Practice Address - Country:US
Practice Address - Phone:818-394-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT127916106H00000X
CALMFT143025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty