Alyssa Rose Kesling, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52119 Issued in CA

Practice address

2030 Sutter PL Ste 1000
Davis Mob Internal Medicine #1000
Davis, CA 95616-6215

Phone

(530) 750-5904

Fax

(530) 750-5905

NPI assigned

Dec 22, 2014

Last updated

Jul 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alyssa Rose Mangabay Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1871981001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 SUTTER PL STE 1000",
            "address_2": "DAVIS MOB INTERNAL MEDICINE #1000",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956166215",
            "telephone_number": "530-750-5904",
            "fax_number": "530-750-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESLING",
        "first_name": "ALYSSA",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "MANGABAY",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samara Kemp, CNM
• Daniel J Kennedy, MD
• Hilary Dowd Kennedy, MA, LMFT, LPCC
• Richard C. Kennedy Jr., D.D.S.
• Sean Canary Kennedy, MD
• Bokyoung Keum
• Sara Khan
• Seema Khan, M.D.
• Kimya Khodamardi, DMD
• Yasmin Gabriella Khouri

• Physician Assistant in Davis, CA
• Providers in Davis, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.