Provider Demographics
NPI:1477392587
Name:PEPPER, ALISHA NICOLE (PMHNP-BC, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:NICOLE
Last Name:PEPPER
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:MS
Other - First Name:ALISHA
Other - Middle Name:NICOLE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6309 TRISTANIA CT
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-9105
Mailing Address - Country:US
Mailing Address - Phone:720-326-8488
Mailing Address - Fax:
Practice Address - Street 1:6309 TRISTANIA CT
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CA
Practice Address - Zip Code:95436-9105
Practice Address - Country:US
Practice Address - Phone:720-326-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022116363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily