MEDICARE: ALISON URDAN M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	MFC39537	CA

General Provider Information

NPI Number	:	1487783791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON URDAN M.A.

Provider Business Mailing Address
First Line	:	614 SANTA CLARA AVE
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-3316
Country	:	US
Telephone Number	:	510-649-9320
Fax Number	:	510-521-5599

Provider Business Practice Location Address
First Line	:	5737 THORNHILL DR
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-2144
Country	:	US
Telephone Number	:	510-587-3231
Fax Number	:	510-587-3231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2007
Last Update Date	:	05/26/2019

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