Healthcare Provider Details

I. General information

NPI: 1336795491
Provider Name (Legal Business Name): MS. CHRISTIAN M ALCALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 MISSION ST
SAN FRANCISCO CA
94103-2911
US

IV. Provider business mailing address

1895 HARMON ST
BERKELEY CA
94703-2415
US

V. Phone/Fax

Practice location:
  • Phone: 415-597-8000
  • Fax:
Mailing address:
  • Phone: 510-472-4786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: