Healthcare Provider Details

I. General information

NPI: 1790908242
Provider Name (Legal Business Name): ALISHA CHRISTINE SWANSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GEER RD
TURLOCK CA
95380-3311
US

IV. Provider business mailing address

2080 NEBELA DR
ATWATER CA
95301-2551
US

V. Phone/Fax

Practice location:
  • Phone: 209-633-3057
  • Fax:
Mailing address:
  • Phone: 559-284-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72174
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number72174
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: