Healthcare Provider Details

I. General information

NPI: 1245805449
Provider Name (Legal Business Name): ALYSSA TOWNSEND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32326 CLINTON KEITH RD STE 201
WILDOMAR CA
92595-7317
US

IV. Provider business mailing address

720 SAINT JAMES DR
WILMINGTON NC
28403-2937
US

V. Phone/Fax

Practice location:
  • Phone: 951-528-2148
  • Fax:
Mailing address:
  • Phone: 910-660-8200
  • Fax: 910-660-8199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: