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General NPI Number Information
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NPI Number | 1063068443
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Entity Type | Individual
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Provider Name | ALYSSA KATE HURTADO
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Gender | Female
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 2828 FORD ST
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City | OAKLAND
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State | CA
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Zip | 94601-2114
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Country | US
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Telephone | 510-926-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 35364 RAMSGATE DR
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City | NEWARK
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State | CA
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Zip | 94560-1445
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Country | US
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Telephone | 518-312-3555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 88768
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 115546
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 088559-01
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW88768
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License Number State | CA
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