Healthcare Provider Details

I. General information

NPI: 1992308167
Provider Name (Legal Business Name): MEREDITH ALLING AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 E COLORADO BLVD
PASADENA CA
91106-5900
US

IV. Provider business mailing address

425 W GLENDON WAY
ALHAMBRA CA
91803-3545
US

V. Phone/Fax

Practice location:
  • Phone: 626-389-2346
  • Fax:
Mailing address:
  • Phone: 313-574-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number122593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: