Healthcare Provider Details

I. General information

NPI: 1912817073
Provider Name (Legal Business Name): ALEJANDRA CERVANTES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14239 W BELL RD STE 110
SURPRISE AZ
85374-2470
US

IV. Provider business mailing address

1860 N 95TH LN STE 105
PHOENIX AZ
85037-4333
US

V. Phone/Fax

Practice location:
  • Phone: 623-544-1631
  • Fax: 623-975-6144
Mailing address:
  • Phone: 623-544-1631
  • Fax: 623-975-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: