Provider Demographics
NPI:1417644121
Name:ALVES, MYA ASHLYN (PA-C)
Entity Type:Individual
Prefix:
First Name:MYA
Middle Name:ASHLYN
Last Name:ALVES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 23RD ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3203
Mailing Address - Country:US
Mailing Address - Phone:707-298-2011
Mailing Address - Fax:
Practice Address - Street 1:2440 23RD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3203
Practice Address - Country:US
Practice Address - Phone:707-298-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant