Provider Demographics
NPI:1356223648
Name:SELIMOV, ALYSSA VALENTINA (DNP, NP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:VALENTINA
Last Name:SELIMOV
Suffix:
Gender:F
Credentials:DNP, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3701
Mailing Address - Country:US
Mailing Address - Phone:302-750-0353
Mailing Address - Fax:
Practice Address - Street 1:877 W FREMONT AVE STE N3
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2332
Practice Address - Country:US
Practice Address - Phone:650-521-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95035884363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health