Healthcare Provider Details

I. General information

NPI: 1821593781
Provider Name (Legal Business Name): PATRICIA ALANIZ MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 03/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E STATE ST
REDLANDS CA
92374-3518
US

IV. Provider business mailing address

707 E STATE ST
REDLANDS CA
92374-3518
US

V. Phone/Fax

Practice location:
  • Phone: 909-798-5536
  • Fax:
Mailing address:
  • Phone: 909-798-5536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number25037
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number25037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: