Provider Demographics
NPI:1295532299
Name:MCMILLAN, ALYSON L (MSW, ASW)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:L
Last Name:MCMILLAN
Suffix:
Gender:
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2656 GREEN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-9025
Mailing Address - Country:US
Mailing Address - Phone:916-813-3994
Mailing Address - Fax:
Practice Address - Street 1:3330 CAMERON PARK DR STE 400
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7652
Practice Address - Country:US
Practice Address - Phone:916-813-3994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW122483104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker