Healthcare Provider Details

I. General information

NPI: 1174413892
Provider Name (Legal Business Name): LOURDES ALVAREZ-MORENO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

157 UNION ST
MARLBOROUGH MA
01752-1228
US

IV. Provider business mailing address

16791 CASTROVILLE BLVD
SALINAS CA
93907-9029
US

V. Phone/Fax

Practice location:
  • Phone: 508-481-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2390205
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: