Provider Demographics
NPI:1639631567
Name:DEBELLIS, ALYSSA N (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:N
Last Name:DEBELLIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3569 VINTON AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4870
Mailing Address - Country:US
Mailing Address - Phone:315-289-8036
Mailing Address - Fax:
Practice Address - Street 1:8900 BEVERLY BLVD STE 250
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-2438
Practice Address - Country:US
Practice Address - Phone:310-423-2641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010357363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily