Healthcare Provider Details

I. General information

NPI: 1760165559
Provider Name (Legal Business Name): ALISON JOHNSTON NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 MILLER AVE
MILL VALLEY CA
94941-2953
US

IV. Provider business mailing address

15 CAZNEAU AVE
SAUSALITO CA
94965-1801
US

V. Phone/Fax

Practice location:
  • Phone: 415-847-8573
  • Fax:
Mailing address:
  • Phone: 415-847-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberA-3453394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: