Healthcare Provider Details

I. General information

NPI: 1841988789
Provider Name (Legal Business Name): MEGHAN MARIE ALONSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 THE ALAMEDA
SAN JOSE CA
95126-1141
US

IV. Provider business mailing address

431 EL CAMINO REAL APT 4221
SANTA CLARA CA
95050-7416
US

V. Phone/Fax

Practice location:
  • Phone: 408-293-7767
  • Fax: 408-300-9663
Mailing address:
  • Phone: 805-286-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303998
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number303998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: