Healthcare Provider Details

I. General information

NPI: 1588451660
Provider Name (Legal Business Name): GLADYS B ALEJANDREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E SAN JACINTO AVE
PERRIS CA
92571-2833
US

IV. Provider business mailing address

1127 PALISADES ST
PERRIS CA
92570-2514
US

V. Phone/Fax

Practice location:
  • Phone: 951-210-1768
  • Fax:
Mailing address:
  • Phone: 951-442-0923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: