| NPI | 1295572592 |
|---|---|
| Former Name | ALYSSA SAN JOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 2024054174) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN180416) |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |