Kennisha Allen

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Vallejo, CA

NPI 1770145252 · NPPES record last updated Jul 3, 2019

Key facts

NPI
1770145252
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
285 Larissa LN
Vallejo, CA 94590-7601
Phone
(510) 850-4065
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

285 Larissa LN
Vallejo, CA 94590-7601

Mailing address

285 Larissa LN
Vallejo, CA 94590-7601
Phone (510) 850-4065

Other providers in Vallejo, CA

All providers in Vallejo, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.