Provider Demographics
NPI:1316712235
Name:CAPELLINO, ALYSSA KAELYN
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KAELYN
Last Name:CAPELLINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NEW STINE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3787
Mailing Address - Country:US
Mailing Address - Phone:661-215-5066
Mailing Address - Fax:323-714-0112
Practice Address - Street 1:8910 BUTTERFLY ROSE AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-0001
Practice Address - Country:US
Practice Address - Phone:661-421-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician