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General NPI Number Information
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NPI Number | 1538932165
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Entity Type | Individual
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Provider Name | ALYSSA RENAE AHUMADA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1601 E CHESTNUT AVE
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City | SANTA ANA
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State | CA
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Zip | 92701-6322
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Country | US
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Telephone | 714-558-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 TOWN AND COUNTRY DR UNIT 5733
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City | NORCO
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State | CA
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Zip | 92860-8187
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Country | US
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Telephone |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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