MEDICARE: TERSA ALONZO

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	2355S0801X	Speech-Language Assistant	9782	CA

General Provider Information

NPI Number	:	1699627158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERSA ALONZO

Provider Business Mailing Address
First Line	:	1317 DEL NORTE RD STE 100
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-8363
Country	:	US
Telephone Number	:	805-485-2000
Fax Number	:	805-351-0869

Provider Business Practice Location Address
First Line	:	1317 DEL NORTE RD STE 100
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-8363
Country	:	US
Telephone Number	:	805-485-2000
Fax Number	:	805-351-0869

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

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ TERSA ALONZO ” Practice Location

Language	Start Address	Practice Location

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