Healthcare Provider Details

I. General information

NPI: 1699682336
Provider Name (Legal Business Name): ALYSSIA NAOMI MALLOIAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2879 JAMACHA RD # 1015
EL CAJON CA
92019-4397
US

IV. Provider business mailing address

2879 JAMACHA RD # 1015
EL CAJON CA
92019-4397
US

V. Phone/Fax

Practice location:
  • Phone: 619-259-0286
  • Fax:
Mailing address:
  • Phone: 619-259-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: