Individual
ALYSSA BIANCONI MOMTAHENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT 139124
Contact information
Practice address
775 CANYON RD, REDWOOD CITY, CA 94062-3023
(650) 868-9129
Mailing address
PO BOX 81, REDWOOD CITY, CA 94064-0081
(650) 590-9946
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
LMFT139124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
942581686
COUNTY
CA
Enumeration date
10/16/2019
Last updated
04/26/2024
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