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General NPI Number Information
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NPI Number | 1639962020
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Entity Type | Individual
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Provider Name | ALYSSA V NAVA
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 875 PERIMETER DR
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City | MOSCOW
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State | ID
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Zip | 83844-9803
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Country | US
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Telephone | 208-885-6757
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 HOGAN CT
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City | MERCED
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State | CA
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Zip | 95340-8112
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Country | US
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Telephone | 209-489-7951
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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 | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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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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