Healthcare Provider Details

I. General information

NPI: 1265336101
Provider Name (Legal Business Name): AUDRA J. ALEJANDREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PALM ST
SANTA CRUZ CA
95060-4758
US

IV. Provider business mailing address

230 CHILVERTON ST # B
SANTA CRUZ CA
95062-1144
US

V. Phone/Fax

Practice location:
  • Phone: 916-213-5838
  • Fax:
Mailing address:
  • Phone: 916-213-5838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: