Individual
ALYSSA MATOBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(559) 256-5200
Mailing address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(559) 256-5200
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50147
PHYSICAL THERALIST ASSISTANT
CA
Enumeration date
08/01/2019
Last updated
08/01/2019
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