Healthcare Provider Details

I. General information

NPI: 1396661310
Provider Name (Legal Business Name): KIMBERLY ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44199 MONROE ST
INDIO CA
92201-3096
US

IV. Provider business mailing address

44199 MONROE ST
INDIO CA
92201-3096
US

V. Phone/Fax

Practice location:
  • Phone: 951-715-5050
  • Fax: 951-784-4986
Mailing address:
  • Phone: 951-715-5050
  • Fax: 951-784-4986

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: