Provider Demographics
NPI:1992014153
Name:KINNE, ALLISON MAKENA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MAKENA
Last Name:KINNE
Suffix:
Gender:F
Credentials:LMFT
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 321
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-0321
Mailing Address - Country:US
Mailing Address - Phone:916-547-9961
Mailing Address - Fax:530-410-0010
Practice Address - Street 1:65 MAIN ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9494
Practice Address - Country:US
Practice Address - Phone:530-283-2465
Practice Address - Fax:530-410-0010
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA84798106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty