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General NPI Number Information
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NPI Number | 1891807533
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Entity Type | Individual
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Provider Name | ALISSA E. SCANLIN PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3468 MT DIABLO BLVD B203
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City | LAFAYETTE
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State | CA
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Zip | 94549-3957
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Country | US
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Telephone | 925-283-3902
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Fax | 707-371-2433
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Provider Business Mailing Address
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Address Line | 6 LOIS LN
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City | LAFAYETTE
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State | CA
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Zip | 94549-3057
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Country | US
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Telephone | 925-283-3902
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Fax | 707-371-2433
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY20873
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License Number State | CA
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