Individual
ALYSSA MEDIAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 W AVENUE J, LANCASTER, CA 93534-2824
(818) 741-2906
Mailing address
50 BLACKBIRD ST, EDWARDS, CA 93523-2614
(786) 318-4699
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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