Alyssa Marie Wellness, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ALYSSA MARIE WELLNESS, INC

Practice address

15300 Ventura Blvd Ste 509
Sherman Oaks, CA 91403-5812

Phone

(909) 461-0408

NPI assigned

Jan 24, 2019

Organization subpart

No

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

Authorized official

Name

Alyssa Mancao, LCSW

Title

LCSW/ Ceo

Phone

(909) 461-0408

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1134683063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD STE 509",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD STE 509",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035812",
            "telephone_number": "909-461-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALYSSA MARIE WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "MANCAO",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "LCSW/ CEO",
        "authorized_official_telephone_number": "909-461-0408",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.