Healthcare Provider Details

I. General information

NPI: 1982522959
Provider Name (Legal Business Name): ALYSA CUTLER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24021 CALLE DE LA PLATA
LAGUNA HILLS CA
92653
US

IV. Provider business mailing address

7206 ROCKRIDGE DR
HUNTINGTON BEACH CA
92648-7020
US

V. Phone/Fax

Practice location:
  • Phone: 183-324-7911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: