Provider Demographics
NPI:1316051931
Name:ALLINSON, PHYLLIS A (MFT)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:A
Last Name:ALLINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 462098
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92046-2098
Mailing Address - Country:US
Mailing Address - Phone:760-809-9551
Mailing Address - Fax:760-294-2933
Practice Address - Street 1:250B E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2803
Practice Address - Country:US
Practice Address - Phone:760-809-9551
Practice Address - Fax:760-294-2933
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 28861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC 28861OtherMFT LICENSE