Healthcare Provider Details

I. General information

NPI: 1548845803
Provider Name (Legal Business Name): ROSANOEMI ALVAREZ MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 FOLSOM BLVD STE 196
SACRAMENTO CA
95826-3257
US

IV. Provider business mailing address

9360 NO NAME UNO STE 130
GILROY CA
95020-3535
US

V. Phone/Fax

Practice location:
  • Phone: 443-764-8913
  • Fax:
Mailing address:
  • Phone: 443-764-8913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: