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General NPI Number Information
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NPI Number | 1922130947
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Entity Type | Organization
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Legal Business Name | TWCA INCORPORATED
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 3468 MT DIABLO BLVD SUITE 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 | 925-283-2421
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Fax | 707-371-2433
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ALISSA E. SCANLIN
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Credential | PSYD
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Telephone | 925-283-3902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 20873
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License Number State | CA
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