Provider Demographics
NPI:1932819851
Name:KASSIS, ALLISON (MA, APCC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KASSIS
Suffix:
Gender:F
Credentials:MA, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10940 FAIR OAKS BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-5958
Mailing Address - Country:US
Mailing Address - Phone:916-426-2757
Mailing Address - Fax:
Practice Address - Street 1:10940 FAIR OAKS BLVD STE 600
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-5958
Practice Address - Country:US
Practice Address - Phone:916-426-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12328101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health