Healthcare Provider Details

I. General information

NPI: 1093623597
Provider Name (Legal Business Name): ALINA JZEL GOLEZ DEMONTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 E 16TH ST APT 3
LONG BEACH CA
90813-2136
US

IV. Provider business mailing address

7251 SANTA BARBARA CT
FONTANA CA
92336-2904
US

V. Phone/Fax

Practice location:
  • Phone: 909-977-0108
  • Fax:
Mailing address:
  • Phone: 909-977-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: