Provider Demographics
NPI:1124442629
Name:CROSS, ALISA (DC)
Entity type:Individual
Prefix:DR
First Name:ALISA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BEAN CREEK RD
Mailing Address - Street 2:118
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4133
Mailing Address - Country:US
Mailing Address - Phone:914-844-6646
Mailing Address - Fax:
Practice Address - Street 1:111 BEAN CREEK RD
Practice Address - Street 2:118
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4133
Practice Address - Country:US
Practice Address - Phone:914-844-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor