Healthcare Provider Details

I. General information

NPI: 1275136855
Provider Name (Legal Business Name): ALYSSA ARIANA ZIZZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41421 DATE ST STE 101
MURRIETA CA
92562-7079
US

IV. Provider business mailing address

41421 DATE ST STE 101
MURRIETA CA
92562-7079
US

V. Phone/Fax

Practice location:
  • Phone: 855-454-3784
  • Fax:
Mailing address:
  • Phone: 855-454-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number29066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: