Healthcare Provider Details

I. General information

NPI: 1861725780
Provider Name (Legal Business Name): ALLISON JAYNE WOMACK M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON JAYNE MORLEY B.A.

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 3RD ST SUITE 108
SACRAMENTO CA
95818-1100
US

IV. Provider business mailing address

1914 7TH ST
SACRAMENTO CA
95811-7008
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-2479
  • Fax:
Mailing address:
  • Phone: 916-869-2932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: