MEDICARE: ALYSSA MIA ESCAMILLA

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
1	225200000X	Physical Therapy Assistant		CA

General Provider Information

NPI Number	:	1619806882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MIA ESCAMILLA

Provider Business Mailing Address
First Line	:	130 E 8TH ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 E 8TH ST
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2223
Country	:	US
Telephone Number	:	619-500-6877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ ALYSSA MIA ESCAMILLA ” Practice Location

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