Provider Demographics
NPI:1932970258
Name:ROSS, ALYSSA (MS CS SLP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:MS CS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 HOWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4229
Mailing Address - Country:US
Mailing Address - Phone:650-244-9961
Mailing Address - Fax:
Practice Address - Street 1:1209 HOWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4229
Practice Address - Country:US
Practice Address - Phone:650-244-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist