Healthcare Provider Details

I. General information

NPI: 1891580122
Provider Name (Legal Business Name): MARIA ALEJANDRA ALVAREZ QUINTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date: 06/10/2026
Reactivation Date: 07/21/2026

III. Provider practice location address

1281 POPLAR SPRING RD
CHULA VISTA CA
91915-2514
US

IV. Provider business mailing address

1281 POPLAR SPRING RD
CHULA VISTA CA
91915-2514
US

V. Phone/Fax

Practice location:
  • Phone: 619-904-0672
  • Fax:
Mailing address:
  • Phone: 619-904-0672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number4247-5678-1468
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: