Provider Demographics
NPI:1831845221
Name:CROOK, ALISSA HEATH (ASW)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:HEATH
Last Name:CROOK
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:MS
Other - First Name:ALISSA
Other - Middle Name:MARIE
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4022 SUNRISE BOULEVARD
Mailing Address - Street 2:SUITE 120, PMB 354
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742
Mailing Address - Country:US
Mailing Address - Phone:916-363-1553
Mailing Address - Fax:916-363-1638
Practice Address - Street 1:630 BERCUT DR STE C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-0110
Practice Address - Country:US
Practice Address - Phone:916-363-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2024-10-28
Deactivation Date:2022-08-11
Deactivation Code:
Reactivation Date:2023-08-31
Provider Licenses
StateLicense IDTaxonomies
CAASW1262611041C0700X, 1041C0700X
CA1041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program