Active NPI
Jessica Lynn Alliss, CMT
- Mechanotherapist
- Yucca Valley, CA
National Provider Identifier
1073808234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 10878
- Practice address
- 57475 29 Palms Hwy
Suite 101
Yucca Valley, CA 92284-2906 - Phone
- (760) 365-9878
- Fax
- (206) 309-0387
- NPI assigned
- Jun 16, 2011
- Last updated
- Jun 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 10878 | CA | Primary |
Addresses
Primary practice location
57475 29 Palms Hwy
Suite 101
Yucca Valley, CA 92284-2906
Mailing address
57475 29 Palms Hwy
Suite 101
Yucca Valley, CA 92284-2906
Phone (760) 365-9878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10878 | Other | CA | CALIFORNIA MASSAGE THERAPY COUNCIL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10878 | CA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1073808234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57475 29 PALMS HWY",
"address_2": "SUITE 101",
"city": "YUCCA VALLEY",
"state": "CA",
"postal_code": "922842906",
"telephone_number": "760-365-9878",
"fax_number": "206-309-0387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57475 29 PALMS HWY",
"address_2": "SUITE 101",
"city": "YUCCA VALLEY",
"state": "CA",
"postal_code": "922842906",
"telephone_number": "760-365-9878",
"fax_number": "206-309-0387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLISS",
"first_name": "JESSICA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "CMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-16",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "CA",
"license": "10878",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA MASSAGE THERAPY COUNCIL",
"identifier": "10878",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yucca Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.