Provider Demographics
NPI:1518964360
Name:COOK, ALISON JO (DPM, MS)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:JO
Last Name:COOK
Suffix:
Gender:F
Credentials:DPM, MS
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:JO
Other - Last Name:COOK CILLIERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21297 FOOTHILL BLVD
Mailing Address - Street 2:202
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-1554
Mailing Address - Country:US
Mailing Address - Phone:510-583-1331
Mailing Address - Fax:510-563-4384
Practice Address - Street 1:21297 FOOTHILL BLVD
Practice Address - Street 2:202
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-1554
Practice Address - Country:US
Practice Address - Phone:510-583-1331
Practice Address - Fax:510-563-4384
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE37510213E00000X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E37510Medicaid
CA000E37510Medicaid
000E37510Medicare PIN