Individual provider Active NPI

Alyssa Catherine Fajayan

  • Social Worker
  • Reno, NV
National Provider Identifier
1154774479
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
4600 Kietzke LN
Suite O-260
Reno, NV 89502-5033
Phone
(775) 825-9995
Fax
(775) 825-9877
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

4600 Kietzke LN
Suite O-260
Reno, NV 89502-5033

Mailing address

PO Box 554
Greenville, CA 95947-0554
Phone (530) 284-7007

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

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1154774479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 554",
            "city": "GREENVILLE",
            "state": "CA",
            "postal_code": "959470554",
            "telephone_number": "530-284-7007",
            "fax_number": "530-284-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 KIETZKE LN",
            "address_2": "SUITE O-260",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895025033",
            "telephone_number": "775-825-9995",
            "fax_number": "775-825-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJAYAN",
        "first_name": "ALYSSA",
        "middle_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.