Healthcare Provider Details

I. General information

NPI: 1356274518
Provider Name (Legal Business Name): ALIXINA CLERROBRUN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

IV. Provider business mailing address

11 KNIGHT BAYOU DR
DAYTON TX
77535-6132
US

V. Phone/Fax

Practice location:
  • Phone: 760-299-5181
  • Fax: 877-214-4220
Mailing address:
  • Phone: 561-201-1634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: