Healthcare Provider Details

I. General information

NPI: 1205525243
Provider Name (Legal Business Name): LIZA ALVARADO DNP A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25186 HANCOCK AVE STE 210
MURRIETA CA
92562-5998
US

IV. Provider business mailing address

25186 HANCOCK AVE STE 210
MURRIETA CA
92562-5998
US

V. Phone/Fax

Practice location:
  • Phone: 951-215-6747
  • Fax: 619-268-5255
Mailing address:
  • Phone: 951-215-6747
  • Fax: 619-268-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LIZA P ALVARADO
Title or Position: CEO
Credential: NP
Phone: 619-228-3492