Provider Demographics
NPI:1902256845
Name:STOLZ, ALISSA DAPPAS
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:DAPPAS
Last Name:STOLZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 EMERSON DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-4807
Mailing Address - Country:US
Mailing Address - Phone:630-485-0159
Mailing Address - Fax:
Practice Address - Street 1:2021 YGNACIO VALLEY RD STE C202
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3392
Practice Address - Country:US
Practice Address - Phone:925-945-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP10051235Z00000X
CASP28210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist