Healthcare Provider Details

I. General information

NPI: 1487199584
Provider Name (Legal Business Name): ALISON ALDERDICE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 544
PETALUMA CA
94953-0544
US

IV. Provider business mailing address

PO BOX 544
PETALUMA CA
94953-0544
US

V. Phone/Fax

Practice location:
  • Phone: 415-505-2133
  • Fax:
Mailing address:
  • Phone: 415-505-2133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number28838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: