Healthcare Provider Details
I. General information
NPI: 1285557678
Provider Name (Legal Business Name): TATIANA FE ALVAREZ-MELGOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31651 FILLE DR
WINCHESTER CA
92596-9149
US
IV. Provider business mailing address
31651 FILLE DR
WINCHESTER CA
92596-9149
US
V. Phone/Fax
- Phone: 951-331-0546
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 95418017 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: