MEDICARE: ALYSSA MARY LOZANO

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1083566152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MARY LOZANO

Provider Business Mailing Address
First Line	:	2918 PROFESSIONAL PKWY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30907-3593
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2918 PROFESSIONAL PKWY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30907-3593
Country	:	US
Telephone Number	:	706-489-0188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ ALYSSA MARY LOZANO ” Practice Location

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