Provider Demographics
NPI:1942665237
Name:BAKER, ALYSSA SUSANNE (NP)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:SUSANNE
Last Name:BAKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4616
Mailing Address - Country:US
Mailing Address - Phone:760-884-4500
Mailing Address - Fax:619-567-7775
Practice Address - Street 1:1045 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4616
Practice Address - Country:US
Practice Address - Phone:760-884-4500
Practice Address - Fax:619-567-7775
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027570363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner