Healthcare Provider Details

I. General information

NPI: 1225952849
Provider Name (Legal Business Name): STAPHANY GABRIELA ALVAREZ CORTEZ PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 N RAMONA BLVD
SAN JACINTO CA
92583-3324
US

IV. Provider business mailing address

2679 FORESTRUN ST
HEMET CA
92543-8430
US

V. Phone/Fax

Practice location:
  • Phone: 951-929-1954
  • Fax:
Mailing address:
  • Phone: 951-929-1954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: