MEDICARE: MS. ALYSSA CHRISTINE CARBAJAL

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	235Z00000X	Speech-Language Pathologist	34573	CA

General Provider Information

NPI Number	:	1124959135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALYSSA CHRISTINE CARBAJAL

Provider Business Mailing Address
First Line	:	7500 VAQUERO AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93308-6431
Country	:	US
Telephone Number	:	661-589-7336
Fax Number	:	661-587-9413

Provider Business Practice Location Address
First Line	:	7500 VAQUERO AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93308-6431
Country	:	US
Telephone Number	:	661-589-7336
Fax Number	:	661-587-9413

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

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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