Individual
ALYSSA JORDAN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2596 AVOCET WAY, LINCOLN, CA 95648-2479
(916) 600-0829
Mailing address
2596 AVOCET WAY, LINCOLN, CA 95648-2479
(916) 600-0829
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XDJ90128065F
BLUE CROSS COMP
CA
Enumeration date
11/05/2018
Last updated
11/05/2018
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