Healthcare Provider Details

I. General information

NPI: 1922552561
Provider Name (Legal Business Name): ALEJANDRA SALDANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEJANDRA S CARRILLO LVN

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1679 EAST MAIN ST. SUITE 102
EL CAJON CA
92021-2831
US

IV. Provider business mailing address

1679 E MAIN ST STE 102
EL CAJON CA
92021-5212
US

V. Phone/Fax

Practice location:
  • Phone: 619-441-1907
  • Fax:
Mailing address:
  • Phone: 619-441-1907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number272772
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number272772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: