Most Relevant Information
Provider Data
| NPI Number: | 1003027137 |
| Provider Name: | JESSICA LYNN ALLEN RAS #M0605161317 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/24/2007 |
| Last Updated: | 12/01/2011 |
Provider Practice Location
2403 PROFESSIONAL DR
SUITE 101
SANTA ROSA
CA
954033007
Practice Location Phone/Fax
| Phone: | 7075443295 |
| Fax: | 7075449011 |
Provider Mailing Location
2403 PROFESSIONAL DR
SUITE 101
SANTA ROSA
CA
954033007
Provider Mailing Phone/Fax
| Phone: | 7075443295 |
| Fax: | 7075449011 |