Active NPI
Allissa Diane Lopez, M.A., LPCC 5695
- Professional Counselor
- Bakersfield, CA
National Provider Identifier
1952677783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5695
- Practice address
- 820 34TH St
Bakersfield, CA 93301-2283 - Phone
- (661) 203-7067
- Fax
- (661) 861-0339
- NPI assigned
- Mar 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | PCCI 7 | CA | |
| Mental Health Counselor | 101YM0800X | PCCI 7 | CA | |
| Professional Counselor | 101YP2500X | 5695 | CA | Primary |
Addresses
Primary practice location
820 34TH St
Bakersfield, CA 93301-2283
Mailing address
820 34TH St
Bakersfield, CA 93301-2283
Phone (661) 203-7067
Other names 1
- Allissa Diane Pederson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCCI 7 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1952677783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 34TH ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933012283",
"telephone_number": "661-203-7067",
"fax_number": "661-861-0339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 34TH ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933012283",
"telephone_number": "661-203-7067",
"fax_number": "661-861-0339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "ALLISSA",
"middle_name": "DIANE",
"name_prefix": "Ms.",
"credential": "M.A., LPCC 5695",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-27",
"last_updated": "2021-03-31",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "PCCI 7",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "PCCI 7",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "5695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALLISSA",
"last_name": "PEDERSON",
"middle_name": "DIANE",
"credential": "M.A., LPCC 5695",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.