Healthcare Provider Details

I. General information

NPI: 1376467688
Provider Name (Legal Business Name): ALYSSA MARIE BORAL MSW, MPH, ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1126 W FOOTHILL BLVD STE 180
UPLAND CA
91786-3786
US

IV. Provider business mailing address

3102 DUNKIRK DR
OXNARD CA
93035-1262
US

V. Phone/Fax

Practice location:
  • Phone: 909-488-4006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW135913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: