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NPI Code Detail

MEDICARE: ALLYSSA GREENE

MEDICARE: ALLYSSA GREENE
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
1106S00000XBehavior TechnicianRBT-17-31921CA

General Provider Information

NPI Number : 1598271512
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSSA GREENE
Provider Business Mailing Address
First Line : 612 S MYRTLE AVE STE 100
Second Line :
City : MONROVIA
State : CA
Zip : 91016-3406
Country : US
Telephone Number : 800-207-0272
Fax Number :
Provider Business Practice Location Address
First Line : 6876 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-2860
Country : US
Telephone Number : 800-207-0272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2017
Last Update Date : 10/23/2025

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Directions to “ ALLYSSA GREENE ” Practice Location

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