Provider Demographics
NPI:1871112912
Name:SMITH, ALISSA
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:BELCZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6402 E HIGHTREE LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2448
Mailing Address - Country:US
Mailing Address - Phone:714-520-1884
Mailing Address - Fax:
Practice Address - Street 1:6402 E HIGHTREE LN
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-2448
Practice Address - Country:US
Practice Address - Phone:714-520-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist