Healthcare Provider Details

I. General information

NPI: 1790604882
Provider Name (Legal Business Name): MIKHAELA ALFORQUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 PALOMAR AIRPORT RD STE 350
CARLSBAD CA
92011-1451
US

IV. Provider business mailing address

1918 MILLENIA AVE APT 211
CHULA VISTA CA
91915-3086
US

V. Phone/Fax

Practice location:
  • Phone: 760-710-2460
  • Fax:
Mailing address:
  • Phone: 904-646-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: