Provider Demographics
NPI:1003260209
Name:NAJERA, ALYSSA R (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:R
Last Name:NAJERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1192
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-1192
Mailing Address - Country:US
Mailing Address - Phone:209-968-1707
Mailing Address - Fax:209-336-0293
Practice Address - Street 1:460 N YOSEMITE AVE STE 9
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361
Practice Address - Country:US
Practice Address - Phone:209-968-1707
Practice Address - Fax:209-336-0293
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA866181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical