Basic Information
| Provider Information | |||||||||
| NPI: | 1003493024 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRATT | ||||||||
| FirstName: | ALEXIA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8621 PARKERLAND CT | ||||||||
| Address2: | |||||||||
| City: | ORANGEVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956624461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162235144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9300 VALLEY CHILDRENS PL | ||||||||
| Address2: | |||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936368762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593533000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2021 | ||||||||
| LastUpdateDate: | 04/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95218421 | CA | N | Nursing Service Providers | Registered Nurse | 363LP0200X | 95017197 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.