Provider Demographics
NPI:1790864866
Name:ALYSON COLE
Entity Type:Organization
Organization Name:ALYSON COLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-899-0477
Mailing Address - Street 1:8492 EVERGLADE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3615
Mailing Address - Country:US
Mailing Address - Phone:916-899-0477
Mailing Address - Fax:916-391-4247
Practice Address - Street 1:8492 EVERGLADE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3615
Practice Address - Country:US
Practice Address - Phone:916-899-0477
Practice Address - Fax:916-391-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARW0895OtherCOUNSELOR