Provider Demographics
NPI:1568803153
Name:HASS, ALLISON (MA LMFT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HASS
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8850 WILLIAMSON DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-9965
Mailing Address - Country:US
Mailing Address - Phone:916-803-0234
Mailing Address - Fax:
Practice Address - Street 1:8850 WILLIAMSON DR # 167
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9965
Practice Address - Country:US
Practice Address - Phone:916-538-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105842106H00000X
CA105824106H00000X
CA74486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105824OtherLICENSED MARRIAGE FAMILY THERAPIST