Healthcare Provider Details

I. General information

NPI: 1295923324
Provider Name (Legal Business Name): ARTEMIZA AVALOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 BALDWIN ST SUITE A
SALINAS CA
93906-3681
US

IV. Provider business mailing address

237 RACE ST
SAN JOSE CA
95126-4823
US

V. Phone/Fax

Practice location:
  • Phone: 837-449-7974
  • Fax:
Mailing address:
  • Phone: 408-971-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: