Provider Demographics
NPI:1487783791
Name:URDAN, ALISON (MA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:URDAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3316
Mailing Address - Country:US
Mailing Address - Phone:510-649-9320
Mailing Address - Fax:510-521-5599
Practice Address - Street 1:5737 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2144
Practice Address - Country:US
Practice Address - Phone:510-587-3231
Practice Address - Fax:510-587-3231
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2019-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39537103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical