Provider Demographics
NPI:1689681058
Name:GREENHILL, ALISA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ALISA
Middle Name:
Last Name:GREENHILL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 TIERRA WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4041
Mailing Address - Country:US
Mailing Address - Phone:530-885-6164
Mailing Address - Fax:530-889-5298
Practice Address - Street 1:145 TIERRA WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4041
Practice Address - Country:US
Practice Address - Phone:530-885-6164
Practice Address - Fax:530-889-5298
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20536106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist