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General NPI Number Information
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NPI Number | 1508652249
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Entity Type | Individual
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Provider Name | ALYSSA BRIANA VERNON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 638 E 87TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90002-1013
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Country | US
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Telephone | 480-584-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 1871 SHAVER LAKE AVE
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City | TULARE
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State | CA
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Zip | 93274-7806
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Country | US
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Telephone | 480-584-2361
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 229920
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034765
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License Number State | CA
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