Healthcare Provider Details

I. General information

NPI: 1023792371
Provider Name (Legal Business Name): ALYSSA JANE BAGASBAS AFICIAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 SHADELANDS DR BLDG 10
WALNUT CREEK CA
94598-2538
US

IV. Provider business mailing address

2730 SHADELANDS DR BLDG 10
WALNUT CREEK CA
94598-2538
US

V. Phone/Fax

Practice location:
  • Phone: 925-266-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: