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NPI Code Detail

MEDICARE: ALYSSA MICKSCHL

MEDICARE: ALYSSA MICKSCHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1073084604
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MICKSCHL
Provider Business Mailing Address
First Line : 3031 C ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-3326
Country : US
Telephone Number : 916-442-2396
Fax Number :
Provider Business Practice Location Address
First Line : 23901 CALABASAS RD STE 1069
Second Line :
City : CALABASAS
State : CA
Zip : 91302-1583
Country : US
Telephone Number : 626-720-7266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2018
Last Update Date : 04/15/2025

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Directions to “ ALYSSA MICKSCHL ” Practice Location

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