=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811853948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLORA THERAPEUTIC SERVICES, A LICENSED CLINICAL SOCIAL WORKER PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2026
-----------------------------------------------------
Last Update Date | 01/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1503 MACDONALD AVE STE A-750
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94801-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-859-3781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1503 MACDONALD AVE STE A-750
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94801-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-859-3781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ELLEN VARGAS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 510-859-3781
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------