Healthcare Provider Details

I. General information

NPI: 1194646323
Provider Name (Legal Business Name): MARIA ISABEL ALCOCER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29061 W. CLARKSON AVE. SPC#16
CANTUA CREEK CA
93608
US

IV. Provider business mailing address

PO BOX 301
CANTUA CREEK CA
93608-0301
US

V. Phone/Fax

Practice location:
  • Phone: 559-630-9560
  • Fax:
Mailing address:
  • Phone: 559-630-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberA2162635
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: