Provider Demographics
NPI:1750058038
Name:METCALF, ALLISON (MSW, ACSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:METCALF
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 OLD TOWN AVE STE 201C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2933
Mailing Address - Country:US
Mailing Address - Phone:619-278-2410
Mailing Address - Fax:
Practice Address - Street 1:3990 OLD TOWN AVE STE 201C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2933
Practice Address - Country:US
Practice Address - Phone:619-278-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 101Y00000X
CA1164071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor