Healthcare Provider Details

I. General information

NPI: 1659202273
Provider Name (Legal Business Name): ALYSSA JORDAN ANDRION NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 REGAL CT
SAN JOSE CA
95127-1245
US

IV. Provider business mailing address

4151 REGAL CT
SAN JOSE CA
95127-1245
US

V. Phone/Fax

Practice location:
  • Phone: 408-476-1311
  • Fax:
Mailing address:
  • Phone: 408-476-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032908
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: