Provider Demographics
NPI:1902248305
Name:ORACH, ALLISON MARIE RUSSELL (MSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE RUSSELL
Last Name:ORACH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MAIRE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 LLEWELLYN AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008
Mailing Address - Country:US
Mailing Address - Phone:408-379-3790
Mailing Address - Fax:408-364-4013
Practice Address - Street 1:251 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:408-379-3790
Practice Address - Fax:408-364-4013
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical