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NPI Code Detail

MEDICARE: ALYSSA GAWRONSKI

MEDICARE: ALYSSA GAWRONSKI
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
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1740654839
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA GAWRONSKI
Provider Business Mailing Address
First Line : 25402 PACIFICA AVE
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-3854
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25402 PACIFICA AVE
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-3854
Country : US
Telephone Number : 949-238-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2015
Last Update Date : 05/15/2023

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Directions to “ ALYSSA GAWRONSKI ” Practice Location

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