Healthcare Provider Details

I. General information

NPI: 1841054103
Provider Name (Legal Business Name): JOANE ALONSO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S ANAHEIM BLVD STE 250
ANAHEIM CA
92805-3872
US

IV. Provider business mailing address

5710 SPAHN AVE
LAKEWOOD CA
90713-1240
US

V. Phone/Fax

Practice location:
  • Phone: 714-527-6000
  • Fax: 714-527-2371
Mailing address:
  • Phone: 669-213-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number64031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: