Healthcare Provider Details

I. General information

NPI: 1922748946
Provider Name (Legal Business Name): JOHANA ELIZABETH ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 N PERRIS BLVD STE N-I
PERRIS CA
92571-3254
US

IV. Provider business mailing address

2560 N PERRIS BLVD STE N-I
PERRIS CA
92571-3254
US

V. Phone/Fax

Practice location:
  • Phone: 951-315-4124
  • Fax:
Mailing address:
  • Phone: 951-315-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSSUDBLOC
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: