Healthcare Provider Details

I. General information

NPI: 1720918642
Provider Name (Legal Business Name): ALEXANDER SENEN JUAREZ-ALLISON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 CARLOS BEE BLVD
HAYWARD CA
94542-1520
US

IV. Provider business mailing address

25200 CARLOS BEE BLVD
HAYWARD CA
94542-1520
US

V. Phone/Fax

Practice location:
  • Phone: 517-763-5416
  • Fax: 517-763-5416
Mailing address:
  • Phone: 517-763-5416
  • Fax: 517-763-5416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: