Provider Demographics
NPI:1760357917
Name:HARRIS, ALISA SHEREI
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:SHEREI
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2759
Mailing Address - Country:US
Mailing Address - Phone:530-527-5637
Mailing Address - Fax:530-527-0249
Practice Address - Street 1:818 MAIN ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2759
Practice Address - Country:US
Practice Address - Phone:530-527-5637
Practice Address - Fax:530-527-0249
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker