Provider Demographics
NPI:1700023439
Name:FORSYTH, ALISON ANN
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ANN
Last Name:FORSYTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 MODOC RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3922
Mailing Address - Country:US
Mailing Address - Phone:805-295-0174
Mailing Address - Fax:
Practice Address - Street 1:22 W MICHELTORENA ST
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6522
Practice Address - Country:US
Practice Address - Phone:805-295-0174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor