Basic Information
Provider Information
NPI: 1053434514
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLEMANDI
FirstName: ROCKY
MiddleName: DEAN
NamePrefix: MR.
NameSuffix:  
Credential: MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 542 OCEAN ST
Address2: SUITE K
City: SANTA CRUZ
State: CA
PostalCode: 950606622
CountryCode: US
TelephoneNumber: 8314590444
FaxNumber: 8314590665
Practice Location
Address1: 290 PIONEER ST
Address2:  
City: SANTA CRUZ
State: CA
PostalCode: 950602133
CountryCode: US
TelephoneNumber: 8314590444
FaxNumber: 8314590665
Other Information
ProviderEnumerationDate: 04/09/2007
LastUpdateDate: 04/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
106H00000XMFC 52549CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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