Individual provider Active NPI

Alyssa Granados

  • Chiropractor
  • Apple Valley, CA
National Provider Identifier
1912686379
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
36677 Issued in CA
Practice address
18522 Outer Hwy 18 Ste 104
Apple Valley, CA 92307-2321
Phone
(760) 646-8525
NPI assigned
Jul 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 36677 CA
Chiropractor 111N00000X 36677 CA Primary

Addresses

Primary practice location

18522 Outer Hwy 18 Ste 104
Apple Valley, CA 92307-2321

Mailing address

18522 Outer Hwy 18 Ste 104
Apple Valley, CA 92307-2321

Other practice location 1

17330 Bear Valley Rd Ste 105
Victorville, CA 92395-7741
Phone (760) 245-8182

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

LicenseStateTypeSpecialty
36677CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alyssa Chiropractic Inc Chiropractor Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1912686379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18522 OUTER HWY 18 STE 104",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18522 OUTER HWY 18 STE 104",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072321",
            "telephone_number": "760-646-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17330 Bear Valley Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923957741",
            "country_code": "US",
            "telephone_number": "760-245-8182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CA",
            "license": "36677",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.