Healthcare Provider Details

I. General information

NPI: 1164381448
Provider Name (Legal Business Name): ALEJANDRA PRIETO DE CHAVEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 SNOW CREEK DR
PATTERSON CA
95363-8762
US

IV. Provider business mailing address

607 SNOW CREEK DR
PATTERSON CA
95363-8762
US

V. Phone/Fax

Practice location:
  • Phone: 209-988-8065
  • Fax:
Mailing address:
  • Phone: 209-988-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95184911
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: