Healthcare Provider Details

I. General information

NPI: 1730690389
Provider Name (Legal Business Name): ALLISON ELIZABETH ARSOUZY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2017
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR ROAD UNIT B
GREENBRAE CA
94904
US

IV. Provider business mailing address

21400 GOLLER AVE
EUCLID OH
44119-1859
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-6666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS1101371
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number87671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: