Provider Demographics
NPI:1740431170
Name:SIEGEL, ALISON LEIGH (MFT, MA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:LEIGH
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MFT, MA
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:LEIGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT, MA
Mailing Address - Street 1:58 W PORTAL AVE
Mailing Address - Street 2:SUITE # 170
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1304
Mailing Address - Country:US
Mailing Address - Phone:415-377-9851
Mailing Address - Fax:
Practice Address - Street 1:58 W PORTAL AVE
Practice Address - Street 2:SUITE # 170
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1304
Practice Address - Country:US
Practice Address - Phone:415-377-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC # 45104101Y00000X, 106H00000X
CAMFC #45104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health