Healthcare Provider Details

I. General information

NPI: 1386068344
Provider Name (Legal Business Name): ALYSSA LABEL MFC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W 5TH AVE STE 101
ESCONDIDO CA
92025-4843
US

IV. Provider business mailing address

PO BOX 232473
SAN DIEGO CA
92193-2473
US

V. Phone/Fax

Practice location:
  • Phone: 530-444-5503
  • Fax:
Mailing address:
  • Phone: 530-559-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 52726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: