Provider Demographics
NPI:1326756388
Name:FARR, ALYSSA ASHLEY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ASHLEY
Last Name:FARR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27612 RUISENOR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-2727
Mailing Address - Country:US
Mailing Address - Phone:949-338-5897
Mailing Address - Fax:
Practice Address - Street 1:22521 AVENIDA EMPRESA STE 116
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2046
Practice Address - Country:US
Practice Address - Phone:949-338-5897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty