Provider Demographics
NPI:1447902358
Name:PRESTRIDGE, ALISON NICOLE (AMFT, APCC, CADCIII)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE
Last Name:PRESTRIDGE
Suffix:
Gender:F
Credentials:AMFT, APCC, CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4756 SULLIVAN ST APT 201
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-8212
Mailing Address - Country:US
Mailing Address - Phone:805-451-2275
Mailing Address - Fax:
Practice Address - Street 1:4756 SULLIVAN ST APT 201
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8212
Practice Address - Country:US
Practice Address - Phone:805-451-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABIII00150720101YA0400X
CA10855101YP2500X
CA129654106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional