Provider Demographics
NPI:1780860767
Name:YAMASAKI, ALISSA SEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:SEN
Last Name:YAMASAKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:PA
Mailing Address - Zip Code:16851-1122
Mailing Address - Country:US
Mailing Address - Phone:814-954-7607
Mailing Address - Fax:888-965-1813
Practice Address - Street 1:720 PIKE STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:LEMONT
Practice Address - State:PA
Practice Address - Zip Code:16851-1122
Practice Address - Country:US
Practice Address - Phone:888-965-1813
Practice Address - Fax:888-965-1813
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016376103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist