Provider Demographics
NPI:1346049749
Name:CERVANTES, ALYSSA (PT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ACACIA ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3800
Mailing Address - Country:US
Mailing Address - Phone:707-928-7174
Mailing Address - Fax:
Practice Address - Street 1:222 ACACIA ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3800
Practice Address - Country:US
Practice Address - Phone:707-928-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist