Provider Demographics
NPI:1538745351
Name:CONTI, ALYSSA CARROLL (MB, BCH, BAO)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CARROLL
Last Name:CONTI
Suffix:
Gender:F
Credentials:MB, BCH, BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 HASTINGS HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1358
Mailing Address - Country:US
Mailing Address - Phone:626-825-9558
Mailing Address - Fax:
Practice Address - Street 1:2051 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1352
Practice Address - Country:US
Practice Address - Phone:626-825-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program