Provider Demographics
NPI:1538955596
Name:SIDES, ALAN P
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:P
Last Name:SIDES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 W SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8519
Mailing Address - Country:US
Mailing Address - Phone:909-942-1825
Mailing Address - Fax:
Practice Address - Street 1:1039 W SANDSTONE DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-8519
Practice Address - Country:US
Practice Address - Phone:909-942-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA753451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical