Active NPI
Alyssa Zamalloa
- Nutritionist
- Nampa, ID
National Provider Identifier
1104622943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- CNS19019
- Practice address
- 17407 N Flagstaff Way
Nampa, ID 83687-5495 - Phone
- (702) 237-0106
- NPI assigned
- Feb 21, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | CNS19019 | CA | Primary |
Addresses
Primary practice location
17407 N Flagstaff Way
Nampa, ID 83687-5495
Mailing address
17407 N Flagstaff Way
Nampa, ID 83687-5495
Phone (702) 237-0106
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 |
|---|---|---|---|
| CNS19019 | CA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741392000000",
"number": "1104622943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17407 N FLAGSTAFF WAY",
"city": "NAMPA",
"state": "ID",
"postal_code": "836875495",
"telephone_number": "702-237-0106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17407 N FLAGSTAFF WAY",
"city": "NAMPA",
"state": "ID",
"postal_code": "836875495",
"telephone_number": "702-237-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAMALLOA",
"first_name": "ALYSSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-21",
"last_updated": "2025-03-08",
"certification_date": "2025-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "CA",
"license": "CNS19019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.