Healthcare Provider Details
I. General information
NPI: 1952619132
Provider Name (Legal Business Name): ALLIANT INTERNATIONAL UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2010
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
391 ONTARIO DR
LIVERMORE CA
94550-5249
US
IV. Provider business mailing address
1440 BROADWAY, SUITE 610
OAKLAND CA
94612-1568
US
V. Phone/Fax
- Phone: 510-925-6064
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELIZABETH
MILNES
Title or Position: PRINCIPAL
Credential: PSY.D.
Phone: 510-628-9065