Healthcare Provider Details

I. General information

NPI: 1649133067
Provider Name (Legal Business Name): ALENA PACHECO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 LAKESHORE DR
ANCHORAGE AK
99517-2815
US

IV. Provider business mailing address

3105 LAKESHORE DR
ANCHORAGE AK
99517-2815
US

V. Phone/Fax

Practice location:
  • Phone: 907-302-9164
  • Fax: 907-677-7017
Mailing address:
  • Phone: 907-302-9164
  • Fax: 907-677-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-545824
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: