Provider Demographics
NPI:1093209835
Name:HODGE, ALYSSA MEGAN TAYLOR (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:MEGAN TAYLOR
Last Name:HODGE
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:195 PAGE MILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-2073
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:
Practice Address - Street 1:195 PAGE MILL RD STE 103
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-2073
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003483363L00000X
NM81308363L00000X
NY348828363L00000X
NE115711363L00000X
UT141850832363L00000X
TX1019711363L00000X
NC5013692363L00000X
ND201282363L00000X
IA182273363L00000X
KS53-83683-01363L00000X
FL11006980363L00000X
SC24238363LF0000X
GAGAA-NP002990363LF0000X
CA95020221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily