Healthcare Provider Details

I. General information

NPI: 1306246327
Provider Name (Legal Business Name): ALEJANDRINA MORENO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 HALL RD CLINICA SIERRA VISTA-LAMONT ADULT BEHAVIORAL HEALTH
LAMONT CA
93241-1953
US

IV. Provider business mailing address

1400 S UNION AVE STE 100 CLINICA SIERRA VISTA-BEHAVIORAL HEALTH
BAKERSFIELD CA
93307-4179
US

V. Phone/Fax

Practice location:
  • Phone: 661-845-3717
  • Fax: 661-845-3385
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: