Healthcare Provider Details

I. General information

NPI: 1598686404
Provider Name (Legal Business Name): ALEJANDRA REYNA MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEJANDRA PLASCENCIA

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42111 ROAD 128
OROSI CA
93647-9749
US

IV. Provider business mailing address

2743 LAKERIDGE AVE
TULARE CA
93274-7874
US

V. Phone/Fax

Practice location:
  • Phone: 559-931-6790
  • Fax:
Mailing address:
  • Phone: 559-931-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number2961707ABB
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: