Healthcare Provider Details
I. General information
NPI: 1306552146
Provider Name (Legal Business Name): ALYSSA JOY CONNORS CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/25/2023
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2999 REGENT ST STE 524
BERKELEY CA
94705-2120
US
IV. Provider business mailing address
112 LA CASA VIA STE 300
WALNUT CREEK CA
94598-3059
US
V. Phone/Fax
- Phone: 510-495-0310
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 236318 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 95022782 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: