Provider Demographics
NPI:1427104934
Name:ZEDNICEK, ALLISON (MFT)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:ZEDNICEK
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 1:1080 MARINA VILLAGE PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6427
Mailing Address - Country:US
Mailing Address - Phone:805-478-6556
Mailing Address - Fax:805-758-6914
Practice Address - Street 1:1080 MARINA VILLAGE PKWY
Practice Address - Street 2:STE 100
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6427
Practice Address - Country:US
Practice Address - Phone:805-478-6556
Practice Address - Fax:805-758-6914
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMFT01129106H00000X
CAMFC42281106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1770665887Medicare UPIN