ALYSSA EMILEE ODNEAL PA
NPI 1083460992
Physician Assistant - Medical in San Diego, CA
About Alyssa Emilee Odneal Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALYSSA EMILEE ODNEAL PA (NPI 1083460992) is an individual medical provider in San Diego, California, licensed in California (PA65148) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alyssa Emilee Odneal Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Alyssa Odneal's NPI number?
The NPI number for Alyssa Odneal is 1083460992. It was assigned to this individual provider in the NPPES registry on April 30, 2024. The provider is also known as Emilee Alyssa Jernigan.
Where is Alyssa Odneal located?
Alyssa Odneal practices at 3030 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 309-7701.
What is Alyssa Odneal's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Alyssa Odneal enrolled in Medicare?
Yes. Alyssa Odneal is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Alyssa Odneal was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Alyssa Emilee Odneal, PA · NPI 1083460992
Medical physician in San Diego, California. Individual provider, active in the CMS NPPES registry since April 30, 2024.
## Identity
- **NPI:** 1083460992 (Entity type: Individual)
- **Enumerated:** April 30, 2024
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA65148 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3030 CHILDRENS WAY, San Diego, CA 92123-4232
- **Phone:** (858) 309-7701
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** October 16, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083460992) · Data from the CMS NPPES public registry.