Provider Demographics
NPI:1295936136
Name:WILHITE, ALLYSON ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:ELIZABETH
Last Name:WILHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:ELIZABETH
Other - Last Name:WILHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:3209 ESPLANADE STE 130
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0154
Mailing Address - Country:US
Mailing Address - Phone:530-520-1136
Mailing Address - Fax:
Practice Address - Street 1:3209 ESPLANADE STE 130
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973
Practice Address - Country:US
Practice Address - Phone:530-520-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA325996163WP0808X
CA35906106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC35906OtherBOARD OF BEHAVIORAL HEALTH
CA163WP0808XOtherPSYCH NURSE