ALYSSIA JEANEESE MALLORY NPI 1972164192

NPI Information

NPI: 1972164192
Provider Name: ALYSSIA JEANEESE MALLORY
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
4343 WILLIAMSBOURGH DR
SACRAMENTO, CA
ZIP 95823
Phone: (915) 395-3552
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Alyssia Jeaneese Mallory is an addiction (substance use disorder) counselor in Sacramento, CA. Alyssia Jeaneese Mallory NPI is 1972164192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4343 WILLIAMSBOURGH DR
SACRAMENTO, CA
ZIP 95823
Phone: (915) 395-3552

The enumeration date for this NPI number is 6/27/2019 and was last updated on 11/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12345	OTHER		N/A
2	12345	OTHER		INTERCOASTCOLLEGE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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