Healthcare Provider Details

I. General information

NPI: 1891344065
Provider Name (Legal Business Name): VIVIENNE ELIZABETH ALONZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 N MOUNTAIN VIEW RD
APACHE JUNCTION AZ
85119
US

IV. Provider business mailing address

13771 N FOUNTAIN HILLS BLVD STE 114
FOUNTAIN HILLS AZ
85268-3733
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: