Individual
ALYSSA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
23701 E EAST FORK RD, AZUSA, CA 91702-1477
(626) 910-1202
Mailing address
23701 E EAST FORK RD, AZUSA, CA 91702-1477
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
755101
CA
Other
Enumeration date
10/07/2025
Last updated
10/21/2025
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