Healthcare Provider Details

I. General information

NPI: 1457553000
Provider Name (Legal Business Name): ALLYSON M HOLMES-KNIGHT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 E 12TH ST SUITE 259
OAKLAND CA
94601-3424
US

IV. Provider business mailing address

2548 JACOBS ST
HAYWARD CA
94541-3384
US

V. Phone/Fax

Practice location:
  • Phone: 510-269-9121
  • Fax: 510-269-9031
Mailing address:
  • Phone: 510-432-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number27770
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number27770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: