1720205842 NPI number — MS. ALLISON ANDERSEN GLATSTEIN MFT

Table of content: MS. ALLISON ANDERSEN GLATSTEIN MFT (NPI 1720205842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720205842 NPI number — MS. ALLISON ANDERSEN GLATSTEIN MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GLATSTEIN
Provider First Name:
ALLISON
Provider Middle Name:
ANDERSEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDERSEN
Provider Other First Name:
ALLISON
Provider Other Middle Name:
NOELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFT INTERN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720205842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 E FOOTHILL BLVD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
ARCADIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91006-2307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-737-1074
Provider Business Mailing Address Fax Number:
626-737-1074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 E FOOTHILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91006-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-737-1074
Provider Business Practice Location Address Fax Number:
626-737-1074
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  IMF48083 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MFT 45664 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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