Healthcare Provider Details

I. General information

NPI: 1346171071
Provider Name (Legal Business Name): ALYSSA JANICE SCHENK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 E J ST
CHULA VISTA CA
91910-6115
US

IV. Provider business mailing address

3663 COWLEY WAY
SAN DIEGO CA
92117-5837
US

V. Phone/Fax

Practice location:
  • Phone: 619-425-9600
  • Fax:
Mailing address:
  • Phone: 949-322-0729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number23435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: