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General NPI Number Information
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NPI Number | 1326854472
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Entity Type | Individual
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Provider Name | ALLISON CLAIRE HOLDER SUDRC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 306 SPRUCE AVE
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-2741
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Country | US
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Telephone | 650-589-9305
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Fax |
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Provider Business Mailing Address
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Address Line | 67 41ST AVE APT 4
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City | SAN MATEO
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State | CA
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Zip | 94403-5156
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Country | US
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Telephone | 650-430-7384
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-MXZFHL
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 22119
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License Number State | CA
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