Healthcare Provider Details

I. General information

NPI: 1295426179
Provider Name (Legal Business Name): HANNAH ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH JOHNSON

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 W THOMAS RD STE 134
PHOENIX AZ
85037-3374
US

IV. Provider business mailing address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

V. Phone/Fax

Practice location:
  • Phone: 623-907-2377
  • Fax:
Mailing address:
  • Phone: 480-459-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9786
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9786
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: