Healthcare Provider Details

I. General information

NPI: 1417302738
Provider Name (Legal Business Name): ALEXANDRA ARGUELLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S TOWNE CENTRE PL SUITE 370
ANAHEIM CA
92806-6122
US

IV. Provider business mailing address

1570 E 17TH ST
SANTA ANA CA
92705-8502
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-4453
  • Fax: 714-937-1531
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: