Individual provider Active NPI

Alyssa Flores

  • Physical Therapist
  • Fairfield, CA
National Provider Identifier
1053004036
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304034 Issued in CA
Practice address
2420 Martin Rd Ste 380
Fairfield, CA 94534-8610
Phone
(707) 437-9001
NPI assigned
May 26, 2023
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 304034 CA Primary

Addresses

Primary practice location

2420 Martin Rd Ste 380
Fairfield, CA 94534-8610

Mailing address

219 Woodland Ave
Woodland, CA 95695-2753
Phone (808) 292-1051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230707001439 CA Practitioner - Physical Therapist in Private Practice 2668831751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Select Cal Physical Therapy PCGroup PAC ID 4789070699, 162 clinicians

Practice addresses (Care Compare)

2420 Martin Rd
Suite 380
Fairfield, CA 94534-8610
Phone (707) 437-9001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304034CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Cal Physical Therapy PC Physical Therapist Current Accepting new patients
Select Cal Physical Therapy PC CurrentSince Jun 11, 2023 Accepting new patients
Select Cal Physical Therapy PC Physical Therapist CurrentSince Jun 11, 2023 Accepting new patients

Locations

1470 Civic Ct
Ste 320
Concord, CA 94520
Phone (925) 326-2211

2420 Martin Rd
Ste 380
Fairfield, CA 94534
Phone (707) 437-9001

707 Lincoln Ctr
Stockton, CA 95207
Phone (209) 470-5101

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1053004036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 WOODLAND AVE",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952753",
            "telephone_number": "808-292-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 MARTIN RD STE 380",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945348610",
            "telephone_number": "707-437-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.