Individual
ALLISON MODESETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8116
Mailing address
101 THE CITY DRIVE SOUTH, RT 128-01, ORANGE, CA 92868
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9999999
EMPLOYEE ID
—
Enumeration date
12/22/2022
Last updated
03/23/2025
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