Healthcare Provider Details

I. General information

NPI: 1972654879
Provider Name (Legal Business Name): ALVARO BERRIOS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 E ELDER ST B
FALLBROOK CA
92028-5000
US

IV. Provider business mailing address

34255 STARPOINT STREET
TEMECULA CA
92592
US

V. Phone/Fax

Practice location:
  • Phone: 760-723-5900
  • Fax: 760-723-5906
Mailing address:
  • Phone: 951-858-9221
  • Fax: 760-723-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: