Healthcare Provider Details

I. General information

NPI: 1841944253
Provider Name (Legal Business Name): ALLISON FRAZIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 MOUNTAIN VIEW ST
ALTADENA CA
91001-4925
US

IV. Provider business mailing address

PO BOX 1320
ROHNERT PARK CA
94927-1320
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-6793
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number136205
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW136205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: