Provider Demographics
NPI:1700674819
Name:MIRANDA, ALYSON ELIZABETH (MA)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:ELIZABETH
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1972 JUNIPERO AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-6041
Mailing Address - Country:US
Mailing Address - Phone:407-446-9208
Mailing Address - Fax:
Practice Address - Street 1:1972 JUNIPERO AVE APT A
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-6041
Practice Address - Country:US
Practice Address - Phone:407-446-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program