Provider Demographics
NPI:1265873640
Name:ALLANSON, JESSICA K (PHD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:K
Last Name:ALLANSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:K
Other - Last Name:ALLANSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSY32303
Mailing Address - Street 1:1265 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122
Mailing Address - Country:US
Mailing Address - Phone:410-570-5438
Mailing Address - Fax:
Practice Address - Street 1:1855 FOLSOM ST STE 304
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4248
Practice Address - Country:US
Practice Address - Phone:415-323-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAPSY32303103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor