Provider Demographics
NPI:1235935602
Name:ALISCA, WILLIAM JR
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:ALISCA
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 WINDSOR WAY APT 111
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6748
Mailing Address - Country:US
Mailing Address - Phone:310-612-4513
Mailing Address - Fax:
Practice Address - Street 1:5650 WINDSOR WAY APT 111
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6748
Practice Address - Country:US
Practice Address - Phone:310-612-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150015106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty