Provider Demographics
NPI:1558169292
Name:ROCHA, ALYSSA CAMILLE (RDN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CAMILLE
Last Name:ROCHA
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DAYBREAK DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2076
Mailing Address - Country:US
Mailing Address - Phone:909-839-3114
Mailing Address - Fax:
Practice Address - Street 1:200 DAYBREAK DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2076
Practice Address - Country:US
Practice Address - Phone:909-839-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered