Provider Demographics
NPI:1790521383
Name:ALLEY, DANICA RAE (R1530201023)
Entity type:Individual
Prefix:
First Name:DANICA
Middle Name:RAE
Last Name:ALLEY
Suffix:
Gender:F
Credentials:R1530201023
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W MORRISON AVE
Mailing Address - Street 2:B
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-6124
Mailing Address - Country:US
Mailing Address - Phone:805-347-3338
Mailing Address - Fax:866-729-9741
Practice Address - Street 1:401 W MORRISON AVE
Practice Address - Street 2:B
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-6124
Practice Address - Country:US
Practice Address - Phone:805-347-3338
Practice Address - Fax:866-729-9741
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1530201023101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty