Individual
ALYSIA NICOLE NESMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3129 S HACIENDA BLVD # 412, HACIENDA HEIGHTS, CA 91745-6304
(626) 715-9557
Mailing address
3129 S HACIENDA BLVD # 412, HACIENDA HEIGHTS, CA 91745-6304
(626) 715-9557
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA58139
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/17/2020
Last updated
10/21/2020
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