| Doctor Name: | JESSICA LYNN ALLEN |
| NPI Number: | 1003027137 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RAS #M0605161317 |
| License Number: | |
| Business Practice Address: | 2403 Professional Dr Suite 101 Santa Rosa, CA - 954033007 |
| Business Phone Number: | 7075443295 |
| Business Fax Number: | 7075449011 |
| Mailing Address: | 2403 Professional Dr, Suite 101 SANTA ROSA |
| State: | CA |
| Postal Code: | 954033007 |
| Phone Number: | 7075443295 |
| Fax Number: | 7075449011 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 12/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |