Provider Demographics
NPI:1699559393
Name:ALONZO, ALYESSA VICTORIA
Entity type:Individual
Prefix:
First Name:ALYESSA
Middle Name:VICTORIA
Last Name:ALONZO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 S Q ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-5631
Mailing Address - Country:US
Mailing Address - Phone:559-656-4883
Mailing Address - Fax:
Practice Address - Street 1:201 N K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4005
Practice Address - Country:US
Practice Address - Phone:559-687-0929
Practice Address - Fax:559-685-8953
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty