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NPI Code Detail

MEDICARE: ALYSSA GRIBBEN

MEDICARE: ALYSSA GRIBBEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1023731619
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA GRIBBEN
Provider Business Mailing Address
First Line : 1815 E HEIM AVE STE 205
Second Line :
City : ORANGE
State : CA
Zip : 92865-3016
Country : US
Telephone Number : 714-464-9080
Fax Number :
Provider Business Practice Location Address
First Line : 1815 E HEIM AVE STE 205
Second Line :
City : ORANGE
State : CA
Zip : 92865-3016
Country : US
Telephone Number : 714-464-9080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2022
Last Update Date : 06/08/2026

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Directions to “ ALYSSA GRIBBEN ” Practice Location

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